Complications of treatment Postoperative complications include excessive inflammation, hematoma, ischemic skin necrosis, infection, granuloma formation, transient paresthesia, scar contracture, persistent proximal interphalangeal (PIP) flexion contracture, distal interphalangeal (DIP) hyperextension deformity, joint stiffness, poor flexion and grip strength, pain, and reflex sympathetic dystrophy (RSD). Comparing surgical incisions, skin necrosis, hematoma and pain problems are more likely with zig-zag exposures, while delayed healing and nerve injuries were reported more often after transverse incisions 7152373. Flare reaction after surgery may be more common in women 1769992. Surgery may actually aggravate the process, and patients may be worse off after surgery than they were before 1769994 . Complication rates following surgery have been reported in the range of 17% to 41% 8994009, 9303892, 9214276, 10050251, 3944435. Complications are nearly twice as common following repeat surgery than for primary surgery 9214276.