Post-Surgery Limitations in Arm Rotation After Distal Ulnar Fracture - Orthopedics

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After undergoing surgery for a distal ulnar fracture, it is common to experience limitations in arm rotation, particularly in the forearm's ability to pronate (turn palm up) and supinate (turn palm down). Given your situation, where you have noted a significant upward angulation of the ulnar bone compared to the radius, it is crucial to understand the potential causes and implications of your symptoms.

Firstly, the limitations in your ability to rotate your forearm could indeed be attributed to several factors. One possibility is that there may be a malalignment or malunion of the fracture, which can affect the mechanics of the forearm. If the ulnar bone is not healing in the correct position, it could lead to restricted motion. Additionally, if there is an associated injury to the triangular fibrocartilage complex (TFCC) or if there is a dislocation of the ulnar head, these could also contribute to the limitation in rotation. The TFCC is a critical structure in the wrist that helps stabilize the distal radioulnar joint, and damage to it can lead to pain and functional limitations.

If you suspect that there is a dislocation or significant injury to the TFCC, it is essential to consult with your orthopedic surgeon as soon as possible. In many cases, if there is a fracture that has not yet healed, surgical intervention may be necessary to address both the fracture and any associated injuries. It is generally advisable to wait until the fracture has sufficiently healed before addressing any additional injuries, as operating on an unstable fracture can complicate recovery and healing.

In terms of your recovery timeline, the healing process for fractures can vary significantly based on several factors, including the type of fracture, the surgical technique used, and your overall health. Typically, bone healing can take anywhere from six to twelve weeks, but functional recovery, particularly for complex injuries involving the wrist and forearm, may take longer. During this time, physical therapy can be beneficial to maintain range of motion and strength in the unaffected joints and muscles.

Regarding your concern about returning to work and the need for hand dexterity, it is essential to communicate openly with your healthcare provider about your occupational needs. They may be able to provide you with a tailored rehabilitation program that focuses on regaining the necessary range of motion and strength in your dominant hand.
In summary, the limitations you are experiencing in forearm rotation after your distal ulnar fracture surgery could be due to malunion, TFCC injury, or other complications. It is crucial to follow up with your orthopedic surgeon to evaluate the current state of your fracture and any associated injuries. They will be able to provide you with a clear plan for further treatment, whether that involves additional surgery or a focused rehabilitation program. Remember, prioritizing proper healing is essential for long-term function and pain-free movement in your wrist and forearm.