Bone Friction and Pain After Wrist Fracture Surgery

Q: Bone Friction and Pain After Wrist Fracture Surgery

Hello： If discomfort occurs only during the transition between hot and cold weather, physical therapy (such as heat therapy) may be sufficient. <br>However, if there is a persistent foreign body sensation and inflammation and pain in the tendons around the wrist due to friction,

Bone friction and pain upon exposure to cold?

It has been a year and a half since I suffered a distal radius fracture, and the titanium alloy plate and screws inside have not yet been removed.
I often feel a friction sensation at the protruding area of the bone when I rotate my palm up and down.
Sometimes, it makes a popping sound and feels fine, but most of the time, there is a rubbing sensation.
Additionally, I can feel discomfort, especially on rainy days or when the weather is cold.
This aching sensation sometimes radiates to my elbow.
Is this related to the plate in my wrist?

Ms. Huang, 20~29 year old female. Ask Date: 2018/07/09

Dr. Li Wenhong reply Orthopedics

Hello: If discomfort occurs only during the transition between hot and cold weather, physical therapy (such as heat therapy) may be sufficient.
However, if there is a persistent foreign body sensation and inflammation and pain in the tendons around the wrist due to friction, a follow-up appointment should be made to assess whether the internal fixation device should be removed.
Changhua Hospital Orthopedics, Dr.
Li Wen-Hong.

Reply Date: 2018/07/09

More Info

After a wrist fracture surgery, particularly one involving the placement of titanium plates and screws, it is not uncommon for patients to experience various sensations, including friction, discomfort, and pain. Your description of feeling a "friction" sensation when rotating your wrist, along with occasional popping sounds, is something that many patients report after similar procedures.
The presence of the titanium plate and screws can sometimes lead to a sensation of friction or discomfort, especially if the hardware is located close to the skin surface or if there is any irritation of the surrounding soft tissues. This is particularly true in cases where the hardware may be prominent, as you described. The popping sound you hear could be related to the movement of tendons or ligaments over the hardware, or it could be due to the normal movement of the joint itself.

Regarding the discomfort you feel during changes in weather, particularly when it is cold or rainy, this is a phenomenon that many people experience, often referred to as "weather sensitivity." While the exact mechanism is not fully understood, it is believed that changes in barometric pressure and temperature can affect the joints and surrounding tissues, leading to increased sensitivity and discomfort. This is particularly common in individuals who have had previous injuries or surgeries in the affected area.

The pain radiating to your elbow could be attributed to several factors. One possibility is that the wrist joint and elbow joint are interconnected in terms of movement and function. If there is any limitation in wrist mobility due to the hardware or surrounding soft tissue tightness, it can lead to compensatory movements that place additional stress on the elbow. Additionally, nerve irritation or entrapment in the wrist area could also contribute to sensations that radiate up the arm.

It is essential to monitor these symptoms and discuss them with your orthopedic surgeon or a physical therapist. They may recommend imaging studies, such as X-rays or an MRI, to assess the position of the hardware and the condition of the surrounding tissues. Furthermore, they can provide guidance on rehabilitation exercises that may help improve mobility and reduce discomfort.

In terms of management, physical therapy can be beneficial. A therapist can work with you to develop a program that focuses on improving range of motion, strengthening the wrist and forearm muscles, and addressing any compensatory movement patterns that may be contributing to your symptoms. Additionally, modalities such as heat or cold therapy, ultrasound, or electrical stimulation may be used to alleviate pain and promote healing.

If the discomfort persists or worsens, or if you notice any new symptoms such as swelling, increased pain, or changes in function, it is crucial to seek medical attention promptly. In some cases, if the hardware is causing significant discomfort or complications, surgical removal may be considered, although this is typically a last resort.

In summary, the sensations you are experiencing after wrist fracture surgery are not uncommon and can be attributed to several factors related to the hardware, surrounding tissues, and joint mechanics. Engaging with your healthcare provider for a thorough evaluation and tailored rehabilitation plan is the best course of action to address these concerns and improve your overall function and comfort.

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