Post-Fracture Recovery: Key Questions After Wrist Surgery

Post-fracture surgery

Hello, doctor.
I had a car accident on February 7th and sustained a fracture of the radius near the wrist.
The following day, on February 8th, I underwent surgery to implant a steel pin.
My attending physician reviewed the X-rays and said the surgery was very successful, for which I am grateful.
I have a few questions I would like to ask you:
1.
How long after surgery should I start rehabilitation? I am worried that not moving will lead to deterioration, but I am also concerned that moving might affect the healing of the bone or cause the pin to shift.
2.
How can I minimize the risk of long-term complications? Is there a likelihood of developing rheumatoid issues?
3.
I stopped using the splint a week after surgery, but I have read that other patients were advised to keep their fractures immobilized.
Should I put the splint back on? My thumb is positioned at the edge of the splint, which is obstructing blood flow, and I have developed a hard lump in that area, so I removed the splint myself.
4.
I currently cannot rotate my hand, meaning my palm cannot face upward.
Is this normal? I can consciously attempt to rotate it without pain, but I still cannot achieve that movement.
Thank you, doctor, for clarifying these concerns.

Bu zhi suo cuo, 20~29 year old female. Ask Date: 2018/02/22

Dr. Shi Guozheng reply Orthopedics

1.
If the implanted steel pins are well-fixed, rehabilitation can begin the day after surgery.

2.
If the fracture surgery is well-aligned, the likelihood of developing post-traumatic arthritis will be lower, and there will be less pain in the future.

3.
There is no need to use a splint anymore.

4.
It is normal for wrist mobility to be limited immediately after surgery; continuous rehabilitation is necessary for improvement.

Reply Date: 2018/02/22

More Info

After experiencing a wrist fracture and undergoing surgery to insert a pin, it’s understandable to have concerns about recovery and rehabilitation. Here are some key points to consider regarding your post-fracture recovery:
1. Timing for Rehabilitation: Generally, rehabilitation should begin as soon as it is deemed safe by your orthopedic surgeon. This often occurs within a few days after surgery, depending on the stability of the fracture and the surgical procedure performed. Early mobilization is crucial to prevent stiffness and promote circulation, but it must be balanced with the need to allow the bone to heal properly. Your doctor will provide specific guidelines based on your individual case, including when to start physical therapy and what exercises are appropriate.

2. Minimizing Long-term Effects: To minimize the risk of long-term complications such as stiffness or arthritis, it is essential to follow your rehabilitation program closely. Engaging in gentle range-of-motion exercises as soon as permitted can help maintain flexibility. Additionally, ensuring proper nutrition, including adequate calcium and vitamin D intake, supports bone healing. It’s also important to manage any pain effectively, as pain can inhibit movement and lead to compensatory patterns that may cause further issues.

3. Use of a Splint or Cast: The decision to remove a splint or cast should always be made in consultation with your healthcare provider. If you have removed your splint and are experiencing discomfort or issues with circulation, it may be wise to discuss this with your doctor. They may recommend reapplying a splint to protect the area and ensure proper healing. The presence of a hard lump near your thumb could indicate swelling or a hematoma, which should be evaluated by your physician.

4. Limited Range of Motion: It is not uncommon to experience limited range of motion following wrist surgery, especially in the early stages of recovery. The inability to turn your palm upward (supination) could be due to swelling, stiffness, or the healing process itself. As you progress in your rehabilitation, you should gradually regain this motion. Your physical therapist will guide you through specific exercises to improve your range of motion and strength.

5. Potential for Rheumatism: Concerns about developing rheumatism or other inflammatory conditions post-fracture are valid, especially if there is a history of such conditions in your family. However, the primary focus should be on proper rehabilitation and monitoring for any signs of complications. If you notice persistent pain, swelling, or changes in your wrist or hand that do not improve with rehabilitation, it’s important to consult your doctor.

In summary, your recovery process will involve a careful balance of rest and rehabilitation. Regular follow-ups with your orthopedic surgeon and physical therapist are essential to monitor your progress and adjust your treatment plan as needed. Always communicate any concerns or unusual symptoms to your healthcare provider to ensure a safe and effective recovery.

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