Pinning fractured finger local anaesthetic

[dsfbrit]

A week ago I fell and fractured my small finger. I went to Pattaya Memorial Hospital on the Friday evening and arranged to return the next day to have it 'reduced' and pinned under local anaesthetic.

 

The surgeon gave me the local anaesthetic, straightened the finger out and put the finger in a cast.

 

We had agreed on this after he had told me he would only pin it if I had a full anaesthetic so I was fully unconscious. I told him that I am 67 years old with an underlying heart condition and this was a very bad idea.

 

Yesterday I went back to have another x-ray and the fracture is looking ok from the front angle, but the side angle shows it would benefit from pinning if i want full motion.

 

I have always funded my own health and so don't have an insurance company to discuus this with.

 

I am happy to fund this, but I am not going to risk a full anaesthetic just to be able to 'make a fist'.

 

In the west, it is common to have this type of pinning with a local anaesthetic. Surely it is available here as well, I just need to find it.

 

Any help would be appreciated

 

 

Edited June 27, 2021 by dsfbrit

[tonray]

Normally for something like a finger / wrist etc they would use a nerve block to block nerve signals just to the hand and wrist. Very common in carpal tunnel surgery.

[dsfbrit]

Thanks Tonray for your reply.

 

When I went to A and E on the Friday evening, I was told that is what would happen.

 

On the Saturday I was given 3 nerve block injections that numbed the area, I felt no pain at all. I have had 2 hip replacement operations, so had no problems watching what was going on as I feel quite relaxed in this environment.

 

As he was bending and pulling the finger back into place, I asked him why he couldn't now do the pinning operation.

 

He said that as it had not hurt me maybe when I came back yesterday, they could use just a nerve block for the pinning.

 

Yesterday it was a different surgeon who would not do this.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited June 27, 2021 by dsfbrit

[tonray]

1 hour ago, dsfbrit said:

Thanks Tonray for your reply.

 

When I went to A and E on the Friday evening, I was told that is what would happen.

 

On the Saturday I was given 3 nerve block injections that numbed the area, I felt no pain at all. I have had 2 hip replacement operations, so had no problems watching what was going on as I feel quite relaxed in this environment.

 

As he was bending and pulling the finger back into place, I asked him why he couldn't now do the pinning operation.

 

He said that as it had not hurt me maybe when I came back yesterday, they could use just a nerve block for the pinning.

 

Yesterday it was a different surgeon who would not do this.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Some doctors don't like to be watched. Many years ago I had a tumor removed from my shoulder....doctor first said he would use a nerve block...but after an initial incision he told me he was going to use general and knock me out because he might have to do some weird contortions of my arm and shoulder and he didn't want me to freak out. I was already under a general sedative too...so I said..."sure just keep those drinks coming".....

[dsfbrit]

That sounds painful...

 

I believe nowadays there is a screen / curtain put between me and my hand, so I would see nothing anyway.

 

I would happily close my eyes if asked.

[Sheryl]

This can be done under either regional anesthetic (nerve block) or general. Regional anesthetic will be quite adequate at numbing the area. I can only assume that either the doctor is not adept at administering it or afraid you'll become agitated and nto keep still.

 

Best I can advise is to see a different doctor.

 

There is a hand specialist at BPH

https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=176&depid=22

 

Or, top hand specialist in Bangkok:

https://phyathai2international.com/doctor.php?pid=148&lang=en

 

The above will be less expensive than BPH per se but factoring in the cost of travel to Bkk (which might involve 2 trips, or several nights stay, as first you have to see him to  book the procedure) it may amount to about the same thing.

[dsfbrit]

Sheryl, thanks very much for the reply.

 

I have just contacted Prof Songcharoen.

 

I am not certain, but I believe I need to get this pinned within so many days of the accident on 18th june.

 

I suspect the Professor may be very busy and not available next week.

 

BPH - Before I had my 2 hip resurfacing operations 10 years ago, I had some bad advice from BPH.

 

I still use BPH for my dental work, they are very good, but I would rather go somewhere else locally for this if it is possible.

 

That is why I went to PMH.

 

Do you think it has to be BPH if i am unable to see the professor.

 

Is there anywhere else locally?

 

Once again thanks very much for your advice. You have advised me before in the fairly distant past and each time your suggestions have been excellent.

 

regards

 

 

 

 

Edited June 27, 2021 by dsfbrit

[Sheryl]

1 hour ago, dsfbrit said:

Sheryl, thanks very much for the reply.

 

I have just contacted Prof Songcharoen.

 

I am not certain, but I believe I need to get this pinned within so many days of the accident on 18th june.

 

I suspect the Professor may be very busy and not available next week.

 

BPH - Before I had my 2 hip resurfacing operations 10 years ago, I had some bad advice from BPH.

 

I still use BPH for my dental work, they are very good, but I would rather go somewhere else locally for this if it is possible.

 

That is why I went to PMH.

 

Do you think it has to be BPH if i am unable to see the professor.

 

Is there anywhere else locally?

 

Once again thanks very much for your advice. You have advised me before in the fairly distant past and each time your suggestions have been excellent.

 

regards

 

 

 

 

As far as I know, in Pattaya only BPH has a hand specialist. And I have no feedback on him.

 

Besides Sundays at Phyathai 2, Prof. Panupong Songcharoen is at:

 

Thonburi Hospital  Tuesdays and Fridays https://www.thonburihospital.com/searchdoctor

 

Chaophya Hospotal (Thonburi area) thursdays  https://international.chaophya.com/inter/?page=6&doctors=prof-dr-panupan-songcharoen

 

And he can also be booked at the Siriraj Private hospital https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=209&

medical_id=0&day=&startTime=&endTime=

 

These 3 hospitals are all on the other side of the river which is why I did nto mention them initially but if there is tiemn pressure might be worth the trip. Certainly out of all them you should be able to get a booking.

 

Besides being an excellent specialist Prof. Panupong is a lovely  person, very kind and sincere.

[dsfbrit]

Sheryl,

 

Thanks for your help. I will go and research these now.

 

Out of interest and not wishing to libel the doctors at PMH, is pinning a finger only something that can be performed by a senior hand specialist.

 

In my naivety, I thought most orthopedic surgeons had this skill - yet I got the feeling during my recent experience that these younger doctors were happier 'buddying' my finger and fixing the cast than getting involved in surgery.

 

Put simply is pinning a task for senior experts.

 

Thanks again for your help.

 

[Sheryl]

7 hours ago, dsfbrit said:

Sheryl,

 

Thanks for your help. I will go and research these now.

 

Out of interest and not wishing to libel the doctors at PMH, is pinning a finger only something that can be performed by a senior hand specialist.

 

In my naivety, I thought most orthopedic surgeons had this skill - yet I got the feeling during my recent experience that these younger doctors were happier 'buddying' my finger and fixing the cast than getting involved in surgery.

 

Put simply is pinning a task for senior experts.

 

Thanks again for your help.

 

 

Hands are something of a sub-specialty, In Thailand especially.