Improving Supination Limitations After Distal Ulnar Fracture Surgery

Limited supination function after distal ulnar fracture surgery?

Hello Dr.
Wang,
I was involved in a car accident on July 28th of this year, which resulted in a closed distal ulnar fracture in my right arm.
It has been over a month and a half since the surgery, but I still have significant limitations in my ability to perform supination.
When my forearm is in a neutral position, I can hardly achieve any supination.

Can rehabilitation improve this issue? Will this condition gradually improve as the bone heals? I have attached the X-rays from before the surgery, after the surgery, and from my first follow-up visit for your reference.

Thank you, Dr.
Wang.

Simon, 30~39 year old female. Ask Date: 2018/09/12

Dr. Wang Zhaomin reply Rehabilitation

Post-surgery, there are usually issues related to limited joint mobility.
Now that it has been a month and a half, rehabilitation therapy should begin to improve joint function; however, the degree of improvement varies from person to person.
It is recommended to continue follow-up visits and closely collaborate with both the physician and therapist to achieve the best treatment outcomes.

Reply Date: 2018/09/12

More Info

After a distal ulnar fracture surgery, it is common for patients to experience limitations in supination, which is the outward rotation of the forearm. This limitation can be attributed to several factors, including the nature of the injury, the surgical procedure, and the subsequent healing process. Given that you are approximately one and a half months post-surgery, it is essential to understand the recovery timeline and rehabilitation strategies that can aid in improving your range of motion.

Firstly, it is important to recognize that the healing of bones and soft tissues takes time. After a fracture, the body goes through several stages of healing, which can last anywhere from six weeks to several months, depending on the severity of the fracture and the individual’s overall health. During this period, it is not uncommon to experience stiffness and limited mobility in the affected area. The surgical fixation of the bone may also contribute to temporary restrictions in movement.

In your case, the limitation in supination may improve as the bone continues to heal. However, it is crucial to engage in a structured rehabilitation program to facilitate recovery. Physical therapy plays a vital role in restoring function and mobility after a fracture. A physical therapist can design a personalized rehabilitation program that includes exercises to improve range of motion, strength, and coordination. These exercises may involve gentle stretching and strengthening activities that target the muscles and tendons around the wrist and forearm.

Additionally, modalities such as heat therapy, ultrasound, and electrical stimulation may be utilized to alleviate pain and promote healing. It is essential to communicate openly with your physical therapist about your limitations and any discomfort you experience during rehabilitation. They can adjust your program accordingly to ensure that you are progressing safely and effectively.

As for whether the limitations will improve with time, many patients find that their range of motion gradually increases as they continue to rehabilitate and as the bone heals. However, some individuals may experience persistent stiffness or limitations even after the bone has healed. In such cases, additional interventions, such as joint mobilization techniques or more intensive physical therapy, may be necessary.

If you find that your supination remains significantly limited after a few months of rehabilitation, it may be worth discussing further options with your orthopedic surgeon. In some cases, surgical intervention may be considered to address any underlying issues that could be contributing to the limitation in movement.

In summary, while it is common to experience limitations in supination after distal ulnar fracture surgery, engaging in a comprehensive rehabilitation program can significantly improve your range of motion over time. Patience and consistent effort in your recovery process are key. If you have concerns about your progress, do not hesitate to reach out to your healthcare provider for guidance and support.

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