Wrist Fractures: Why Can't I Turn My Palm Up? - Orthopedics

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Wrist fractures, particularly those involving the distal radius or other carpal bones, can lead to a variety of complications during the healing process. After surgical intervention, such as the insertion of pins or plates, it is not uncommon for patients to experience limitations in their range of motion, including the inability to turn the palm up, a movement known as supination.
The inability to supinate your wrist can be attributed to several factors:
1. Soft Tissue Injury: The ligaments, tendons, and muscles surrounding the wrist may have been injured during the fracture or the surgical procedure. This can lead to stiffness and reduced mobility. The soft tissue structures may take longer to heal than the bone itself, resulting in a temporary loss of function.

2. Joint Stiffness: After a wrist fracture, especially if immobilization was required, the joints can become stiff. This stiffness can be exacerbated by scar tissue formation, which may limit the normal gliding motion of tendons and ligaments around the wrist joint.

3. Muscle Weakness: Following a wrist fracture, the muscles that control wrist and forearm movement may weaken due to disuse during the healing process. Weakness in these muscles can make it difficult to perform movements such as turning the palm up.

4. Pain and Discomfort: Pain can also be a significant limiting factor. If you experience pain when attempting to supinate your wrist, your body may instinctively avoid that movement, leading to further stiffness and loss of range of motion.

5. Bone Healing and Alignment: If the fracture did not heal properly or if there is any misalignment of the bones, this could also affect your ability to move your wrist freely. In some cases, malunion or nonunion of the fracture can lead to chronic issues with mobility.

To address your concerns, it is essential to engage in a structured rehabilitation program. Here are some recommendations:
- Physical Therapy: Working with a physical therapist can help you regain strength and flexibility in your wrist. They can provide specific exercises to improve your range of motion and guide you through progressive loading of the wrist to enhance recovery.

- Gentle Stretching: Incorporating gentle stretching exercises can help improve flexibility. It is crucial to perform these exercises within a pain-free range to avoid exacerbating any existing discomfort.

- Gradual Strengthening: Once you have regained some range of motion, your therapist can introduce strengthening exercises to help rebuild muscle strength around the wrist and forearm.

- Heat and Cold Therapy: Applying heat before exercises can help relax the muscles and improve blood flow, while cold therapy can reduce inflammation and pain after activity.

- Follow-Up with Your Surgeon: Regular follow-ups with your orthopedic surgeon are essential to monitor the healing process and ensure that there are no complications. If there are concerns about the alignment of the bones or if you suspect that the fracture has not healed correctly, your doctor may recommend imaging studies to assess the situation.

In conclusion, the inability to turn your palm up after a wrist fracture is likely due to a combination of soft tissue injury, joint stiffness, muscle weakness, and possibly pain. With appropriate rehabilitation and time, many patients can regain their full range of motion. However, it is essential to be patient and consistent with your rehabilitation efforts. If you have ongoing concerns, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.