Post-Fracture Recovery: Ensuring Bone Healing and Managing Discomfort

Post-operative issues following a fracture?

Hello Doctor, I would like to inquire about my condition.
I underwent an open reduction and internal fixation surgery on my left humerus on August 6th, and had the cast removed on September 21st after nearly 7 weeks of immobilization.
Following the cast removal, I attended rehabilitation for occupational therapy and physical therapy.
The therapist noticed muscle stiffness in my left arm and applied significant pressure to loosen it.
I would like to know if this could harm the healing of the bone.
My orthopedic surgeon has scheduled a follow-up appointment on November 2nd for an X-ray to assess the healing status.
During this period, how can I ensure that there is no damage to the bone? Is the absence of pain an indication that the bone has not shifted or is healing well? Recently, I have been experiencing a slight tingling sensation or a feeling of vibration at the surgical site.
Is this a normal healing phenomenon or could it be due to overexertion? Thank you for taking the time to respond amidst your busy schedule! Thank you!

Ms. Zhang, 20~29 year old female. Ask Date: 2020/10/07

Dr. Chen Bochen reply Orthopedics

Hello, Miss Chang.
I would like to inquire about my situation.
I underwent an open reduction and internal fixation surgery on my left humerus on August 6, and I had my cast removed on September 21 after nearly 7 weeks of immobilization.
After the cast was removed, I attended rehabilitation for occupational and physical therapy.
The therapist noticed that my left arm's muscles were stiff and applied strong pressure to loosen them.
I would like to know if this could harm the healing of the bone.
There is no concern regarding the healing of the bone.
My orthopedic surgeon has scheduled a follow-up appointment on November 2 to take X-rays and assess the healing progress.
I would like to understand how to ensure that there is no harm to the bone during this period.
Is it correct to assume that if there is no pain, the bone has not displaced and is healing well?
1.
Self-monitoring of symptoms is important.
If there is a continuous absence of pain, there is no need for excessive worry.
However, if the pain increases, it is advisable to return for an earlier check-up.
2.
It is beneficial to get plenty of sunlight and to supplement with protein and calcium.
Recently, I have been experiencing slight sharp pains or a tingling sensation in the surgical area.
I am unsure if this is a normal healing phenomenon or a sign of overexertion.
3.
Muscle atrophy and weakness in the area of the fracture can often lead to muscle twitching.
Applying heat and engaging in moderate activity will likely improve this over time.
Wishing you a speedy recovery!

Reply Date: 2020/10/07

More Info

Post-fracture recovery is a critical phase that requires careful management to ensure proper bone healing and to alleviate discomfort. After undergoing an open reduction and internal fixation surgery for a left humeral fracture, it is essential to follow a structured rehabilitation program while being mindful of the healing process.

Firstly, it is important to understand that the healing of bones typically occurs in several stages: inflammation, soft callus formation, hard callus formation, and bone remodeling. Each of these stages requires time and appropriate conditions to ensure optimal recovery. The fact that you had your cast removed after approximately seven weeks indicates that your orthopedic surgeon is monitoring your healing progress closely. However, it is crucial to adhere to their recommendations regarding activity levels and rehabilitation exercises.

Regarding your concern about the physical therapist's approach to your muscle stiffness, it is essential to strike a balance between promoting mobility and protecting the healing bone. Gentle stretching and range-of-motion exercises are typically encouraged to prevent stiffness and promote circulation. However, aggressive manipulation or deep tissue massage should be approached with caution, especially in the early stages of recovery. If you feel that the therapist's techniques are causing discomfort or pain, it is important to communicate this to them. They can adjust their methods to ensure that you are not jeopardizing the healing process.

To ensure that your bone is healing properly, regular follow-ups with your orthopedic surgeon are crucial. The X-ray scheduled for November 2 will provide valuable information about the alignment and healing of the fracture. If there is no pain and the bone appears to be in the correct position on the X-ray, it is a good sign that healing is progressing well. However, it is essential to remain vigilant for any signs of complications, such as increased pain, swelling, or changes in sensation.

The sensations of small prickling or a "twitching" feeling in the area of the surgical site can be attributed to several factors. These may include nerve regeneration, scar tissue formation, or even muscle spasms as the surrounding tissues begin to heal. While some discomfort is normal during the recovery process, it is essential to differentiate between typical healing sensations and signs of potential complications. If these sensations become more pronounced or are accompanied by significant pain, it would be prudent to consult your orthopedic surgeon for further evaluation.

In addition to physical therapy, ensuring proper nutrition is vital for bone healing. A diet rich in calcium and vitamin D can support bone health. Foods such as dairy products, leafy greens, and fortified foods can be beneficial. Staying hydrated and maintaining a balanced diet will also aid in your overall recovery.

In conclusion, while it is normal to experience some discomfort during the recovery process, it is essential to communicate openly with your healthcare providers about any concerns you have. Regular follow-ups, appropriate rehabilitation techniques, and a focus on nutrition will all contribute to a successful recovery. If you have any doubts or experience significant changes in your symptoms, do not hesitate to reach out to your orthopedic team for guidance. Your proactive approach to your recovery will play a significant role in ensuring a positive outcome.

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