DD 9 (probable AS) with swollen hand and lots of pain

[flossy2013]

I wondered if anyone else has come across anything like this in their DC?

This is a fairly long story, sorry....

About 18 months ago my DD was bitten by a horse on her left hand. There was no serious damage done, the skin on her palm was grazed, bad bruising on the back of her hand, but no broken bones, fortunately.
She had the wound cleaned under anaesthetic and after a couple of weeks the bruising went and she was back to normal.

Then back in May this year out of the blue her left hand swelled up and it was really painful. Since then it has swollen up regularly, the longest she has gone without a swollen hand is about 3 weeks. Sometimes it's only swollen for one day, sometimes 5 or 6 days in a row. When it's swollen her hand is so painful she can't bear to have anyone or anything touch it and she holds it up in a 'claw-like' position. She gets pins a needles sensations, shooting pains in her thumb/palm and a feeling like her hand is 'under water'.

We have been back to the hospital to see the consultant around 3 times. He originally said it was due to the trauma of the horse bite (which is weird because it didn't swell up until nearly a year after the initial injury), but now he is saying that it shouldn't still be swollen after all this time. He says that because DD holds her hand in this way it is making it worse, which I can understand with her not moving her hand at all it stays swollen, but why does it swell at all? They don't seem to have any answers.

I'm convinced some of the pain she has in her hand is connected to the Aspergers and the associated sensory issues, but I'm not sure if the pain or other sensations come before the swelling then she stops using her hand and holds it in the claw position, or it spontaneously swells then she gets the pain etc (this is what she says happens).

Has anyone else come across similar?

She has now been referred to physio and a psychiatry team that help people after trauma, so hopefully we'll get some ideas on how to help her. So far the consultant has been pretty unsympathetic, I tried to explain about the Aspergers and sensitivity to touch, but he didn't want to listen. He just kept saying that it was 'not normal' for her to be unable to use her hand at all after all this time and that 'there's no reason for her to hold her hand like that' etc, etc. I'm hoping for a bit more understanding from the psych team, they may have a bit more awareness of ASD's, with any luck!

Ds had a finger injury, which progressed to cellulitis (dispite hospital treatment locally)and needed surgery under GA ( he nearly lost the finger and his hand was threatened). He was sent to a hand clinic for therapy, to learn to reuse his hand and get the movement back. We continued with therapy for several weeks , and still do the exercises occasionally. It sounds like your dd could benefit from similar. Ds even now 2 years later is very scared if he thinks the same is happening again. He has a different logic to the rest of us. It was surprising how reduced his hand movement was after only a weeks cellulitis and swelling!
Ask the GP to refer to the hand clinic?

Polter - why do you say not to go down the psych route? I though they may be more understanding and I'm worried about the physio TBH as she will shut down if anyone tries to get her to move it, or attempts to touch it.

Magso - The physio is at the hand clinic, so one of the people there may have more of an idea on what's going on. Hopefully I can get to speak to someone before they get as far as 'man-handling' her!

BTW I don't think she's hypermobile, seen no evidence of it.