Dr. Tollestrup Repairs Peripheral Nerve Damage Through a Complex Surgery
Finally Relief After Enduring Two Years of Pain and Three Botched Surgeries
Corrine came to see Dr. Tollestrup because of severe pain in her right hand. Her story is a cautionary one that underscores the importance of finding the right surgeon. Corrine endured a horrendous two years because her case was so badly botched.
Corrine was originally diagnosed with right carpal tunnel syndrome as well as trigger fingers. A local hand surgeon operated on her to correct the trigger finger problem. She also underwent a carpal tunnel release. For some strange reason, the hand surgeon decided to aggressively “explore” the nerve going to the ring finger due to Corrine’s preoperative symptoms.
Following this surgery, Corrine started to develop new pain in the palm of her right hand. Her hand surgeon then diagnosed her with reactive Dupuytren’s contractures, even though there was no evidence of Dupuytren’s disease in either hand prior to the first surgery.
Corrine went back for a second operation where her hand surgeon removed much of the palmar fascia in the palm of her hand. This fascia is important for bulk and support of the palmar skin.
Following the second surgery, the pain in the palm of Corrine’s right hand became excruciating. The pain was so severe that it left her right hand completely debilitated. She was essentially no longer able to use the hand because she couldn’t stand for anything to touch the skin of the palm of her hand. In addition, she was unable to make a fist because this would increase the pain.
At this point, it was clear that her hand surgeon really had no idea where her pain was coming from. Nevertheless, he decided to operate on her a third time.
In the third surgery, he cut away a large part of the skin and underlying tissue in the palm of the right hand. He then harvested a skin graft from the right arm and used the graft to cover the defect he had created in the palm of the right hand. Unfortunately for Corrine, after healing up from this painful surgery, the pain in her right hand has continued to become progressively worse.
Corrine was referred to Dr. Tollestrup by her pain management physician.
Dr. Tollestrup realized immediately that Corrine’s problem was a unique and difficult one. Based on his knowledge of peripheral nerve anatomy, Dr. Tollestrup knew that the primary problem was that the tiny nerves that normally branch off the main nerves to the fingers and innervate the skin of the palm of the hand had been damaged from all the prior surgery she had undergone.
Based on the fact that there was also pain and numbness radiating into the ring finger, Dr. Tollestrup knew there was a good chance that the main nerve to that finger had been damaged as well.
At this point, Dr. Tollestrup was found himself in a situation where he had to figure out a way to surgically address the damaged nerves in Corrine’s hand in order to get rid of her pain without damaging any other nerves and still preserving the main nerves to the index and middle fingers which were not painful.
This is a position that Dr. Tollestrup finds himself in quite often. In these instances, a patient has a unique, one-of-a-kind problem for which there is no blueprint to follow surgically. In Corrine’s case, the small damaged nerves in the palm of her hand are not even pictured in any anatomy books.
After thinking about the problem for several weeks, Dr. Tollestrup came up with an operative plan requiring intraoperative decisions based on what he saw during the operation.
Dr. Tollestrup took Corrine to the operating room where he performed an 8-hour long operation on Corrine’s hand involving extensive microsurgery. Using an operating microscope, Dr. Tollestrup explored the nerves in Corrine’s right hand. He was able to identify all of the tiny nerves that branched off the main nerves which used to innervate the palmar skin of her right hand. These nerves had all formed painful neuromas on the ends which were stuck in scar tissue underneath the skin graft. This was the reason for the severe pain whenever anything touched the palm of her hand.
Dr. Tollestrup disconnected all of these small nerves and then had to carefully dissect these small nerve fascicles out of the main median nerve without injuring any of the surrounding nerve tissue. The little damaged nerves were dissected out of the main median nerve all the way up above the level of the wrist into the forearm area. At this point, he excised all of the damaged ends of these small nerves and then sewed all four of the small nerve fascicles which were less than 1mm in diameter to a single cadaveric nerve graft. The purpose of sewing the tiny nerves to the nerve graft was to allow the nerves to grow into the graft and burn out without forming new painful neuromas.
At her six week follow up appointment, the results were amazing. Miraculously, Corrine no longer had any pain in her right hand and could easily make a fist which she does in this video*.
Dr. Tollestrup is still following her case closely but it looks like he has surgically solved a complex, unique problem.
Here is what Corrine has to say about here experience with Dr. Tollestrup*.
“After three unsuccessful surgeries on my dominant hand, many years of pain and inability to fully utilize the hand, I can see the “light at the end of a very dark tunnel”. I am so thankful that I found Dr. Tollestrup. After he performed a more than six hour surgery on my hand, in just two months post-op, I am experiencing more comfort and the use of my hand than I have had for years. My prognosis is very optimistic per Dr. Tollestrup. I am certain that I am much better off than before the surgery he performed and am getting more comfortable and better use as time progresses. Dr. Tollestrup spent hours with me in the consultations before, after, and post-op appointments. He is very patient, has an excellent bedside manner, and is the most capable, confident, and experienced surgeon I have met.”
We do not guarantee any specific results or outcomes for surgery, should our practice work on your behalf. Information on this website may be used as a reference for successes we’ve achieved for our patients, and not as an assurance or guarantee for similar results in all instances.