Post-Operative Concerns After Distal Radius Fracture Surgery

Postoperative Issues Following Distal Radius Fracture Surgery

Hello, Doctor.
I underwent a remote distal radius fracture surgery on May 9th (initially a comminuted fracture) using self-funded plates and screws along with artificial bone.
I had follow-up X-ray examinations on May 15th and May 22nd.
The doctor mentioned that the bone alignment looks good, but advised that I do not need to schedule physical therapy and can manage it on my own (focusing on finger movements and wrist joint rotation).
Currently, I have no significant issues with finger movement, but my wrist joint is very stiff and difficult to move.
When I try to move it, it feels very rigid and I am apprehensive.
Should I use my other hand to assist the injured left wrist joint in its movements? My next follow-up appointment is in a month, and I am concerned that my rehabilitation progress may be too slow, potentially leading to future issues with joint mobility.

Lin Zhi-zhe, 30~39 year old female. Ask Date: 2020/05/26

Dr. Shi Guozheng reply Orthopedics

If the fracture in this area is properly reduced and well stabilized through surgery, rehabilitation exercises can begin.
These may include flexion and extension of the fingers, as well as dorsal and palmar flexion of the wrist, following the principle of not causing excessive pain.
Gradually increasing the range of motion is encouraged, and alternating heat and cold therapy can help reduce swelling in the wrist, making rehabilitation easier to conduct.

Reply Date: 2020/05/26

More Info

After undergoing surgery for a distal radius fracture, particularly one that was complex like a comminuted fracture, it is common to have concerns about post-operative recovery and potential complications. Your experience of stiffness in the wrist joint is not unusual, especially after such a significant injury and surgical intervention.

Post-Operative Concerns
1. Stiffness and Range of Motion: It's quite common for patients to experience stiffness in the wrist after surgery. This can be due to several factors, including swelling, immobilization during the healing process, and the body's natural response to injury. The stiffness you are feeling, especially when trying to move your wrist, is likely a result of these factors.
2. Need for Rehabilitation: While your doctor has advised you to perform self-directed rehabilitation, it is essential to understand that structured physical therapy can significantly enhance recovery. A physical therapist can provide tailored exercises that not only improve range of motion but also strengthen the surrounding muscles, which can help support the wrist joint as it heals.

3. Using the Other Hand for Assistance: It is perfectly acceptable to use your other hand to assist in moving your injured wrist. This can help you gradually increase your range of motion without overstraining the injured wrist. However, be cautious not to push it too hard, as this could lead to further injury or pain.

4. Monitoring Progress: Since your next follow-up appointment is a month away, it is crucial to monitor your progress. If you notice significant pain, swelling, or if the stiffness worsens, it would be advisable to contact your healthcare provider sooner. They may recommend an earlier evaluation or even refer you to a physical therapist for more intensive rehabilitation.

5. Potential Complications: While the risk of complications such as malunion or nonunion is relatively low if the fracture has been properly aligned and stabilized, it is still a concern. If you notice any unusual symptoms, such as increased pain, swelling, or changes in skin color around the surgical site, these could be signs of complications that require immediate medical attention.

Recommendations for Recovery
- Gentle Range of Motion Exercises: Start with gentle wrist flexion and extension exercises. You can also try circular motions to promote mobility. If you experience pain, reduce the intensity and frequency of the exercises.

- Ice and Elevation: To manage any swelling, continue to apply ice to the wrist and elevate it when possible. This can help reduce inflammation and improve comfort.

- Gradual Increase in Activity: As you feel more comfortable, gradually increase the complexity of your movements. Incorporate activities that involve gripping and pinching, as these will help strengthen the muscles around the wrist.

- Stay Informed: Educate yourself about the healing process and what to expect. Understanding the timeline for recovery can help manage your expectations and reduce anxiety about your progress.

- Follow-Up Care: Make sure to keep your follow-up appointments and communicate any concerns you have with your healthcare provider. They can provide guidance tailored to your specific situation.

In summary, while stiffness and limited range of motion are common after distal radius fracture surgery, proactive management through gentle exercises, monitoring your symptoms, and possibly seeking physical therapy can significantly enhance your recovery. Always listen to your body and consult your healthcare provider if you have concerns about your healing process.

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