Recovery of Hand Function and Weight Bearing After Distal Radius and Ulnar Fractures

Can the range of motion and weight-bearing ability of the hand be restored after a distal radius and ulnar styloid fracture?

Dear Director Shih,
My mother fell on Monday morning, landing on her right hand, which resulted in a diagnosis of "distal radius and ulnar styloid fractures" as noted in her medical report.
She was immediately taken to the emergency room and received a cast.
On Tuesday afternoon, she underwent a "percutaneous pinning and internal fixation surgery" (the procedure is referred to as S21).
After the surgery, there were two protrusions on her casted hand (I recall seeing two white lines on the X-rays from the front and side views).
The doctor mentioned that the pins could be removed during a follow-up appointment, as she has osteoporosis.
My mother has been quite anxious over the past three days, so she asked me to consult you regarding the following questions:
1.
Why is the area where the pins were inserted more painful than the original injury site? (She describes the pain as coming in waves.)
2.
When can the cast and pins be removed? When can she resume her daily household activities? (She is a homemaker.)
3.
Will she be able to regain the range of motion and weight-bearing capacity in her hand as before the injury? (She is very concerned about this.)
For your reference, my mother will turn 65 in May, has osteoporosis, and has early-stage liver cirrhosis.
Therefore, in the two days following the surgery, she has been taking half a tablet of acetaminophen (the medication starts with the letter A) each morning and evening.
Director Shih, I apologize for the numerous questions, and I greatly appreciate your time and assistance in addressing my mother's concerns.
Thank you very much!

Mr. Shi, 30~39 year old female. Ask Date: 2016/03/24

Dr. Shi Guozheng reply Orthopedics

It is normal to experience throbbing pain at the surgical site or fracture area after surgery.
Approximately six weeks later, the stitches can be removed, and the cast can be taken off.
Generally, recovery can reach a certain level during this time.
Taking pain relievers in moderation can help alleviate pain and facilitate joint mobility or hand movement.

Reply Date: 2016/03/24

More Info

The recovery of hand function and weight-bearing capacity after distal radius and ulnar fractures can be a complex process, especially in older adults with pre-existing conditions such as osteoporosis. Your mother’s situation, involving a fall that resulted in fractures of the distal radius and ulnar styloid, followed by surgical intervention, raises several important considerations regarding her recovery.

1. Pain at the Site of the Surgery: It is not uncommon for patients to experience significant pain at the site of the surgical intervention, even more so than at the original injury site. This can be attributed to several factors, including surgical trauma, inflammation, and the body’s healing response. The presence of hardware, such as pins or screws, can also contribute to discomfort as the body adjusts to the foreign material. Pain that comes in waves may indicate fluctuations in inflammation or muscle tension around the surgical site. It is crucial to manage this pain effectively, and if it becomes severe or unmanageable, it is advisable to consult with her healthcare provider.

2. Timeline for Cast and Hardware Removal: The timeline for removing the cast and any internal fixation devices like pins can vary based on the individual’s healing process. Typically, a cast may be removed within 4 to 6 weeks post-surgery, depending on the stability of the fracture and the surgeon's assessment. The removal of the pins or screws usually occurs later, often around 6 to 12 weeks after surgery, contingent on the healing progress observed through follow-up X-rays. Regular follow-up appointments are essential to monitor the healing process and make timely decisions regarding cast and hardware removal.

3. Return to Daily Activities: The ability to return to daily activities, including household chores, will depend on her recovery progress. After the cast is removed, physical therapy is often recommended to restore range of motion, strength, and function. The timeline for returning to normal activities can vary widely; some patients may begin light activities within weeks of cast removal, while others may take several months to regain full function. It is essential to listen to her body and progress gradually to avoid re-injury.

4. Restoration of Function and Weight Bearing: Regarding the restoration of hand function and the ability to bear weight, many patients can regain a significant portion of their pre-injury capabilities, especially if they engage in a structured rehabilitation program. However, factors such as age, overall health, and the severity of the fractures can influence the extent of recovery. In cases of osteoporosis, there may be a higher risk of future fractures, which can impact the confidence and willingness to engage in weight-bearing activities. It is crucial to work closely with a physical therapist who can tailor a rehabilitation program to her specific needs, focusing on strengthening exercises and gradually increasing the load on her hand.

In summary, while your mother may face challenges in her recovery due to her age and underlying health conditions, with appropriate medical care, pain management, and rehabilitation, there is a good chance she can regain much of her hand function and return to her daily activities. Continuous communication with her healthcare team will be vital in navigating her recovery journey and addressing any concerns that arise.

Similar Q&A

Struggling to Open Hand After Wrist Fracture Surgery: Causes and Solutions

I underwent surgery for a fracture of the radius and ulna, during which two metal plates and one screw were inserted. It has now been a month and a half, and I have been actively participating in rehabilitation. Most of my functions have nearly returned to normal, except for the ...

Dr. Zhan Xian reply Orthopedics
Please visit the orthopedic outpatient clinic for an examination. Thank you.

Improving Grip Strength and Wrist Mobility After Distal Radius Fracture

Hello Doctor: It has been 15 days since the incident and 6 days since the surgery. I have some concerns regarding rehabilitation, as I am worried about potential muscle contractures in the future. 1. Currently, my grip rehabilitation is normal, but I lack strength and cannot gr...

Dr. Shi Guozheng reply Orthopedics
You can perform wrist movements such as making a fist and extending the hand as long as there is no pain. It is also acceptable to do flexion and extension of the wrist.

Post-Operative Complications of Distal Radioulnar Fusion Surgery

Hello Doctor, I have a distal radius and ulnar fracture with joint involvement, and after a delay of three months in treatment, it healed improperly before I went to the hospital for surgery. After two months of rehabilitation post-surgery, I found that I still cannot rotate or f...

Dr. Shi Guozheng reply Orthopedics
After the fusion surgery of the distal radius and ulna, there may be a slight reduction in joint mobility; however, weight-bearing and strength are still possible. Most importantly, this procedure can reduce pain and improve function.

When and How to Rehab After Radius and Scaphoid Fractures: A Guide

Hello, Doctor: I fell and fractured my wrist (distal radius and scaphoid fractures) in mid-September. I underwent surgery to implant a titanium alloy plate and screws. During my follow-up appointment last week, I still felt pain in my wrist. After reviewing the X-rays, the doctor...

Dr. Shi Guozheng reply Orthopedics
Ulnar styloid fractures typically do not require special treatment; however, if there is an associated tear of the triangular fibrocartilage complex (TFCC) between the radius and ulna, intervention is necessary. Rehabilitation involves performing wrist movements in all directions...