Wrist and Elbow Pain After a Car Accident: When to Seek Further Imaging

The wrist cannot rotate, and the elbow feels stiff?

A car accident occurred in July, and I was taken to a nearby hospital where they examined a fracture in the inner bone of my elbow (I was put in a cast).
There was no specific mention of my wrist at that time.
After a week, I returned for a follow-up appointment, and the doctor said the cast could be removed and that I should use a sling for a month.
In the second week, I felt something was off with my wrist, so I went to another hospital for evaluation.
The doctor suspected a fracture in my wrist, but later X-rays indicated it might just be a ligament laxity, which is causing limited mobility and difficulty with rotation.
I need to undergo rehabilitation for a while.
As for my elbow, it still feels stiff.
Now, two months later, my wrist still cannot rotate beyond 45 degrees without pain, and even shaking hands is difficult.
Is it really just ligament laxity? Should I return to the hospital for an MRI or a CT scan?

Niming, 20~29 year old female. Ask Date: 2017/10/05

Dr. Li Yongheng reply Orthopedics

Hello, the car accident injury has resulted in an elbow fracture, and there may also be damage to the wrist, particularly with regard to potential injuries such as scaphoid fractures, triangular fibrocartilage complex (TFCC) tears, and distal radioulnar joint dislocations.
It has been two months since your injury, and your wrist still cannot rotate, with a maximum range of only 45 degrees; any further rotation causes pain, and even shaking hands is difficult, indicating the need for further detailed examination.
Therefore, it is recommended that you undergo an MRI scan as it is necessary.
Wishing you a speedy recovery.

Reply Date: 2017/10/05

More Info

After a car accident, it is not uncommon to experience lingering pain and dysfunction in the wrist and elbow, especially if there was an initial diagnosis of a fracture or soft tissue injury. Your situation, where you have persistent pain and limited range of motion in both the wrist and elbow, raises several important considerations regarding the need for further imaging and potential treatment options.

From your description, it seems that you initially had a diagnosis of an inner elbow fracture, which was treated with a cast. After the cast was removed, you were advised to use a sling for support. However, the ongoing issues with your wrist and elbow suggest that there may be more complex injuries at play. The fact that you are experiencing difficulty with wrist rotation and pain when attempting to move your elbow indicates that there could be underlying issues such as ligament injuries, tendonitis, or even damage to the cartilage or joint surfaces.

In cases like yours, where symptoms persist despite initial treatment, further imaging may be warranted. An MRI (Magnetic Resonance Imaging) is particularly useful for evaluating soft tissue injuries, including ligaments, tendons, and cartilage. It can provide a clearer picture of any potential tears or sprains that may not be visible on X-rays. If there is a concern about bone integrity or if there are suspicions of a more complex fracture that might not have been detected initially, a CT (Computed Tomography) scan could also be beneficial. CT scans offer detailed images of bone structures and can help identify subtle fractures or bone displacement.

Given that you are experiencing significant limitations in movement and pain, it is advisable to consult with an orthopedic specialist who can assess your condition more thoroughly. They may recommend an MRI to evaluate the soft tissues around your wrist and elbow, especially if there is a suspicion of ligamentous injury or tendon damage. Additionally, they may refer you to a physical therapist who can help with rehabilitation exercises designed to restore function and strength to your wrist and elbow.

It is also important to consider that the healing process can vary significantly from person to person. Factors such as the severity of the initial injury, your overall health, and adherence to rehabilitation protocols can all influence recovery time. If you find that your symptoms are not improving or are worsening, it is crucial to seek further medical evaluation sooner rather than later to prevent any long-term complications.

In summary, based on your ongoing symptoms and the complexity of your injuries, pursuing further imaging like an MRI or CT scan is a reasonable next step. This will help clarify the nature of your injuries and guide appropriate treatment. Don't hesitate to advocate for your health and seek the necessary evaluations to ensure a comprehensive approach to your recovery.

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