Recovery from Distal Radius Fracture: Key Questions Answered

Inquiry about distal radius fracture of the left wrist?

Hello Doctor: I previously sustained injuries from a car accident resulting in a comminuted distal radius fracture with displacement and an ulnar styloid fracture.
I underwent surgery for fracture reduction (using a titanium alloy plate and screws for internal fixation).
I would like to ask:
1.
It has been about two months since the surgery, and I feel a catching sensation when raising or lowering my wrist, which prevents my palm from achieving a 90-degree angle with my elbow.
The catching sensation seems to be at the site of the plate fixation.
Should I continue to perform wrist flexion and extension exercises, and should I increase the strength of these movements?
2.
Regarding the ulnar styloid fracture, I experience pain when I supinate my palm.
Is this normal? Should I also increase the strength of the supination movement?
3.
It has been about two months since the surgery, and my primary physician mentioned that the fracture is slowly healing and that I do not need to return for follow-up appointments, just to continue taking calcium supplements.
How many months should I wait before getting an X-ray to assess the healing progress?
4.
Additionally, how long does it typically take for this type of fracture to heal before considering the removal of the plate and screws? I apologize for the inconvenience and thank you very much for your assistance.

Wu Tongxue, 20~29 year old female. Ask Date: 2018/04/16

Dr. Shi Guozheng reply Orthopedics

1.
It is necessary to continue with rehabilitation exercises.

2.
Pain is normal, and the intensity can be increased, but it should not be excessive.

3.
Taking calcium supplements does not seem to be very helpful.

4.
It will take at least a year.

Reply Date: 2018/04/16

More Info

Recovering from a distal radius fracture, especially after a significant injury like yours, can be a complex process that requires careful management and rehabilitation. Here are the answers to your questions based on your current situation:
1. Movement and Stiffness: It is common to experience stiffness and a sensation of "catching" in the wrist after surgery, particularly around the area where the titanium plate is fixed. This can be due to scar tissue formation or the hardware itself. It is essential to continue with gentle range-of-motion exercises as tolerated, but you should avoid forcing any movements that cause significant pain. Gradually increasing the range of motion is important, but it should be done carefully. If you feel that the stiffness is not improving or if the pain worsens, it would be wise to consult with your orthopedic surgeon or a physical therapist for a tailored rehabilitation program.

2. Pain with Forearm Rotation: Experiencing pain when rotating your forearm (pronation and supination) after a ulnar styloid fracture is not uncommon. This could be due to inflammation or irritation around the fracture site or the surrounding soft tissues. You should perform these movements gently and within a pain-free range. If the pain persists or increases, it may indicate that the fracture is not healing as expected, or there may be other complications. Again, consulting with your healthcare provider would be beneficial.

3. Follow-Up X-rays: Typically, follow-up X-rays are recommended around 6 to 8 weeks post-surgery to assess the healing of the fracture. Since you are already two months post-surgery, it would be reasonable to schedule an appointment for imaging if you have concerns about your healing progress. Your doctor may suggest further imaging based on your symptoms and physical examination findings.

4. Healing Time and Hardware Removal: The healing time for distal radius fractures can vary widely depending on several factors, including the severity of the fracture, your age, and overall health. Generally, it can take anywhere from 6 weeks to several months for the bone to heal sufficiently. After adequate healing, if the hardware (plate and screws) is causing discomfort or limiting your range of motion, your surgeon may discuss the possibility of removing it. This decision is usually made based on your recovery progress and any ongoing symptoms.

In addition to these points, it's crucial to maintain a healthy diet rich in calcium and vitamin D to support bone healing. Engaging in physical therapy can also be beneficial to regain strength and function in your wrist and forearm.
Lastly, always listen to your body. If you experience increased pain, swelling, or any new symptoms, do not hesitate to reach out to your healthcare provider. They can provide the best guidance tailored to your specific situation. Recovery from such injuries can be challenging, but with the right approach and support, you can achieve a successful outcome.

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