Recovery After Left Radius Fracture: Managing Elbow Dislocation and Ligament Injury

Fracture of the left radial head accompanied by elbow dislocation and ligament tear?

Hello doctor, I underwent surgery on November 9th due to a car accident, resulting in a left radial fracture with dislocation and ligament rupture.
A titanium alloy plate and anchors were used for fixation, and I did not have a cast post-surgery.
The attending physician advised me to actively try to bend or appropriately extend my arm from time to time, but my range of motion is very limited.
I estimate I can bend it about 85 degrees and extend it to about 35 degrees.
I have difficulty turning my palm upwards and can feel a grainy sensation in my elbow.
After trying a couple of times, I experience soreness or sharp pain.
I'm unsure if my wrist and fingers are also bruised, as their movements are somewhat restricted.
In the morning, they feel stiff and only become somewhat normal after warming up.
Since I'm uncertain about what I can achieve in terms of recovery, I would like to seek assistance from a rehabilitation specialist.
However, I previously asked my doctor, and they mentioned that it would be three months post-surgery; would that be too late?

M, 30~39 year old female. Ask Date: 2020/11/30

Dr. Chen Yongxue reply Orthopedics

Hello, a fracture of the radial head accompanied by dislocation usually leaves varying degrees of sequelae.
Therefore, rehabilitation after surgery is very important.
The progress of rehabilitation should primarily follow the advice of the attending physician.
On one hand, the stability achieved during the surgery is crucial, and on the other hand, the degree of fracture healing as shown on follow-up X-rays is also significant.
Regardless, elbow injuries can easily lead to stiffness as a long-term consequence, so it is advisable to engage in active rehabilitation.
Thank you.

Reply Date: 2020/11/30

More Info

Recovery after a left radius fracture, especially when accompanied by elbow dislocation and ligament injury, can be a complex process that requires careful management and rehabilitation. Given the details of your situation, it’s important to understand both the expected recovery timeline and the strategies for effective rehabilitation.

Firstly, it’s crucial to recognize that after a surgical intervention involving the fixation of a fractured radius with titanium plates and anchors, the healing process typically takes several months. The fact that you did not use a cast post-surgery is not uncommon, as some surgeons prefer to allow for early mobilization to promote healing and prevent stiffness. However, this approach requires diligent attention to rehabilitation exercises to regain range of motion and strength.

From your description, it seems that you are experiencing limited range of motion, particularly in flexion and extension of the elbow, as well as difficulties with supination (turning the palm up). The presence of a "grainy" feeling in the elbow could indicate some residual swelling or scar tissue formation, which is not unusual after such injuries. The pain you experience during movement is also a common symptom as the tissues around the joint heal and adapt.

In terms of rehabilitation, it’s essential to start with gentle range-of-motion exercises. These should be done within a pain-free range to avoid exacerbating any inflammation or discomfort. Gradually increasing the intensity and range of these exercises can help improve flexibility and strength. It’s also important to incorporate wrist and finger exercises, as these areas can become stiff after an injury to the arm.

Regarding your concern about whether it’s too late to seek physical therapy three months post-surgery, the answer is no. It is never too late to start rehabilitation. In fact, many patients benefit significantly from physical therapy even months after their initial injury. A physical therapist can provide a tailored rehabilitation program that focuses on your specific limitations and goals. They can also use modalities such as ultrasound, electrical stimulation, or manual therapy to help reduce pain and improve mobility.

As for the timeline for recovery, it varies widely among individuals. Factors such as age, overall health, the severity of the injury, and adherence to rehabilitation protocols play significant roles. Generally, you can expect to see gradual improvements over the first six months, with many patients achieving substantial recovery by the end of this period. However, full recovery can take longer, especially if there are complications such as persistent pain or stiffness.

In conclusion, it is advisable to consult with a rehabilitation specialist who can assess your current condition and develop a comprehensive plan to address your specific needs. They can guide you through exercises to improve your range of motion, strength, and function while monitoring your progress. Remember, patience and consistency are key components of recovery, and seeking help sooner rather than later can lead to better outcomes.

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