Recovery from Radial Bone Fracture: Concerns and Rehabilitation

Radial fracture

Hello Doctor, I fractured my right radius on January 24th (approximately in the middle) and underwent surgery to implant a steel plate on January 25th.
I had my stitches removed a few days ago.
Since I am an artist, I am very anxious about my recovery.
I have several questions:
1.
I am having difficulty rotating and straightening my arm.
When I try to rotate it, I can clearly feel the protrusion of the steel plate, and it feels hard to the touch.
Does this mean that I will need to have the plate removed later? If removal is necessary, will the surgery affect the nerves and ligaments? How long will the total recovery time take? Does this indicate that the plate may have shifted, and if so, would that require another surgery?
2.
I am experiencing numbness in my thumb and index finger, along with sudden sharp pain.
Pressing on my wrist causes pain.
What does this signify?
3.
If the above issues are normal, can I recover through rehabilitation? When can I start rehabilitation, and what level of rehabilitation should I aim for? How long will it take to recover? Will I be able to fully regain the sensation in my hand as it was before the fracture? Thank you very much for your response!

FL, 20~29 year old female. Ask Date: 2021/02/06

Dr. Chen Yongxue reply Orthopedics

1.
Difficulty in flipping the arm and extending it, with a noticeable protrusion at the site of the steel plate that feels hard to the touch.
I would like to know if this indicates that the plate may need to be removed later.
You are still very young, and it would be better to remove it if necessary.
Will the surgery affect the nerves and ligaments? How long will the total recovery time be, similar to the initial implantation? Bone healing typically takes about three months; does this mean the plate may have shifted? If there is a shift, will another surgery be required? Please monitor for displacement with X-rays.
If there is a shift, will another surgery be necessary?
2.
There is a numbness in the thumb and index finger, accompanied by sudden sharp pain, and pressing on the wrist causes pain.
What does this indicate? Generally, swelling or tendonitis can easily lead to these symptoms.
3.
If the above issues are normal phenomena, when can rehabilitation begin, and what level of rehabilitation can be performed? How long will it take to recover? Is it possible to fully regain the pre-fracture sensation? This varies from person to person; it would be best for your attending physician to provide an answer.

Reply Date: 2021/02/06

More Info

Recovering from a radial bone fracture, especially one that involves surgical intervention like the insertion of a plate, can be a complex process that requires careful management and rehabilitation. Your concerns are valid, and it’s important to address them comprehensively.

1. Concerns about the Plate: It’s not uncommon for patients to feel the plate under the skin, especially in the early stages of recovery. The hardness you feel is likely due to the metal plate, which is designed to stabilize the fracture. Whether or not the plate needs to be removed depends on several factors, including your level of discomfort, the healing progress of the bone, and your functional needs. If the plate is causing significant discomfort or if there are complications like irritation or infection, your orthopedic surgeon may recommend its removal. However, the removal procedure itself is typically straightforward and, when performed by a skilled surgeon, poses minimal risk to surrounding nerves and ligaments.
The total recovery time can vary widely based on individual factors, including the severity of the fracture, your overall health, and adherence to rehabilitation protocols. Generally, bone healing can take anywhere from 6 to 12 weeks, but full functional recovery, especially for activities like painting that require fine motor skills, may take longer.

2. Numbness and Pain: The symptoms you describe in your thumb and index finger, such as numbness and sudden sharp pain, could indicate nerve irritation or compression. This can occur post-surgery due to swelling, scar tissue formation, or even the positioning of the plate. It’s essential to discuss these symptoms with your physician, as they may require further evaluation. In some cases, physical therapy can help alleviate these symptoms by improving mobility and reducing inflammation.

3. Rehabilitation Timeline: Rehabilitation is crucial for regaining strength and function in your hand. Typically, rehabilitation can begin as soon as the surgical site has healed sufficiently, which is often within a few weeks post-surgery. Initially, rehabilitation may focus on gentle range-of-motion exercises to prevent stiffness. As healing progresses, you can gradually incorporate strengthening exercises.
The timeline for rehabilitation varies, but many patients can expect to engage in more active rehabilitation around 4 to 6 weeks post-surgery, depending on the healing status of the bone and the advice of your healthcare provider. The goal of rehabilitation is to restore as much function as possible, and many patients can achieve a level of recovery that allows them to return to their pre-injury activities, including painting.

In conclusion, while the recovery process from a radial bone fracture can be challenging, it is important to remain optimistic and proactive about your rehabilitation. Regular follow-ups with your orthopedic surgeon and physical therapist will be essential in monitoring your progress and addressing any complications that may arise. With dedication to your rehabilitation program, many patients find they can return to their previous levels of function and activity. Always communicate openly with your healthcare team about your concerns and progress to ensure the best possible outcome.

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