Post-Fracture Complications: Seeking Expert Advice for Radial Bone Surgery

Q: Post-Fracture Complications: Seeking Expert Advice for Radial Bone Surgery

Hello, Xiaobu： For a distal radius fracture without displacement or joint surface involvement, casting for six to eight weeks can be considered, and generally, this will yield good results. <br>However, if there is poor reduction or displacement, it is advisable to either re-alig

Poor outcome after radius surgery - the physician recommends surgery?

Hello, doctor.
I sustained a distal radius fracture due to a fall.
After manual reduction in the emergency department, I was sent home with a long arm cast.
I continued to follow up in outpatient clinics, and after four weeks, the long arm cast was changed to a short arm cast.
Six weeks post-surgery, the short arm cast was removed, and I began rehabilitation while continuing outpatient follow-ups.
After six weeks of rehabilitation, during my follow-up visit at the orthopedic clinic, the doctor recommended a CT scan before proceeding with surgical treatment.
The main symptoms include malunion and displacement of the radius, causing significant ulnar prominence at the wrist, and I am unable to supinate or externally rotate my palm.
I would like to know how much hand function can be restored after the surgery.
Since this is my dominant hand, it greatly affects my daily life, and I would like to seek opinions and evaluations from other physicians.
Are there any recommended orthopedic (hand surgery) specialists in the Greater Taipei area?

Xiao Bu, 40~49 year old female. Ask Date: 2017/02/18

Dr. Shen Boquan reply Orthopedics

Hello, Xiaobu: For a distal radius fracture without displacement or joint surface involvement, casting for six to eight weeks can be considered, and generally, this will yield good results.
However, if there is poor reduction or displacement, it is advisable to either re-align the fracture or perform surgical fixation with a plate.
As you mentioned, if there is nonunion affecting wrist joint mobility, there are surgical options available to address this.
It would be best to discuss this thoroughly with a trusted physician to achieve a favorable outcome.
Wishing you good health.

Reply Date: 2017/02/18

More Info

Post-fracture complications, particularly following a radial bone surgery, can be a significant concern for patients, especially when the injury affects the dominant hand. In your case, it appears that you have experienced a radial bone fracture that has not healed properly, leading to complications such as ulnar prominence at the wrist and limited range of motion in your hand.
The first step in addressing your concerns is to understand the nature of your injury and the implications of the proposed surgical intervention. When a fracture does not heal correctly, it can lead to malunion or nonunion, which can result in persistent pain, deformity, and functional limitations. In your situation, the ulnar prominence suggests that the alignment of the bones has been compromised, which can affect the mechanics of the wrist and hand.

Surgical intervention, as suggested by your orthopedic surgeon, may involve realigning the bones and stabilizing them with internal fixation devices such as plates or screws. This procedure aims to restore proper anatomy and function to the wrist and hand. The success of the surgery and the extent of functional recovery will depend on several factors, including:
1. Timing of the Surgery: The sooner the surgery is performed after identifying the malunion, the better the chances for recovery. Delayed intervention can lead to further complications.

2. Quality of the Surgical Technique: The skill and experience of the surgeon play a crucial role in the outcome. A surgeon specializing in hand surgery will be more adept at addressing the complexities of wrist and hand anatomy.

3. Rehabilitation: Post-operative rehabilitation is critical for regaining function. A tailored physical therapy program focusing on range of motion, strength, and functional activities will be essential for recovery.

4. Patient Factors: Your overall health, age, and adherence to rehabilitation protocols will also influence the recovery process.
Regarding your specific question about the potential for functional recovery after surgery, many patients can regain significant function in their hands, especially if the surgery is performed promptly and effectively. However, the extent of recovery can vary widely. Some patients may achieve near-normal function, while others may experience residual limitations, particularly in fine motor skills or strength.

As for finding a recommended orthopedic (hand surgery) specialist in the Greater Taipei area, I suggest looking for hospitals or clinics that have a dedicated hand surgery department. You can also seek referrals from your primary care physician or consult with your current orthopedic surgeon for recommendations. Additionally, consider checking online reviews and patient testimonials to gauge the experiences of others with specific surgeons.

In conclusion, while complications following a radial bone fracture can be concerning, timely surgical intervention and a comprehensive rehabilitation program can significantly improve your functional outcomes. It is essential to maintain open communication with your healthcare team and actively participate in your recovery process.

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