Persistent Wrist Discomfort and Vascular Swelling After Fracture Recovery

The treatment has been completed for nearly a year, but the wrist joint still frequently feels uncomfortable and there is noticeable vascular edema?

On June 6, 2020, the patient sought medical attention for a distal radius fracture and underwent fixation with titanium alloy.
Nearly a year later, the patient still experiences frequent discomfort in the wrist joint and has developed vascular edema.
What measures can be taken to alleviate these symptoms? Should the patient see a rehabilitation specialist, or return to the orthopedic surgeon? What could be the possible conditions? Thank you.

mary, 60~69 year old female. Ask Date: 2021/06/13

Dr. Shi Guozheng reply Orthopedics

Some individuals may experience slower recovery, but continuing rehabilitation can lead to improvement.
It is advisable to consult a rehabilitation specialist.

Reply Date: 2021/06/13

More Info

After experiencing a distal radius fracture and undergoing surgical fixation with titanium alloy, it is not uncommon to encounter persistent discomfort in the wrist and vascular swelling even after a year of recovery. This situation can be attributed to several factors related to the healing process, the nature of the injury, and the surgical intervention.

Firstly, the discomfort you are experiencing may be due to a condition known as post-traumatic wrist stiffness or complex regional pain syndrome (CRPS). After a fracture, especially in the wrist, the surrounding soft tissues, including ligaments, tendons, and muscles, may become stiff and less mobile due to disuse during the healing process. This stiffness can lead to pain and discomfort during movement. Additionally, CRPS can manifest as persistent pain, swelling, and changes in skin color or temperature, often following an injury.
The vascular swelling you mentioned could be a result of several factors, including inflammation, poor circulation, or even lymphatic drainage issues. After a fracture, the body goes through a healing process that involves inflammation, which can lead to swelling. If the swelling persists, it may indicate that the body is still in a state of healing or that there is an underlying issue that needs to be addressed.

In terms of management, it is advisable to consult with a healthcare professional who specializes in rehabilitation, such as a physical therapist or a rehabilitation physician. They can assess your wrist's range of motion, strength, and overall function. A tailored rehabilitation program can help improve mobility, reduce pain, and address any stiffness. Techniques such as manual therapy, stretching exercises, and strengthening exercises can be beneficial. Additionally, modalities like ultrasound therapy or electrical stimulation may be used to alleviate pain and promote healing.

If the discomfort and swelling do not improve with rehabilitation, it may be necessary to return to your orthopedic surgeon for further evaluation. They may want to perform imaging studies, such as X-rays or MRI, to assess the integrity of the bone and surrounding soft tissues. They can also evaluate for any complications related to the fracture or surgery, such as hardware issues or nonunion of the fracture.

In summary, persistent wrist discomfort and vascular swelling after a distal radius fracture can be managed through a combination of rehabilitation and medical evaluation. It is essential to address these symptoms promptly to prevent long-term complications and to restore function to your wrist. Consulting with a rehabilitation specialist is a good first step, and if necessary, follow up with your orthopedic surgeon for further assessment. Your proactive approach to seeking help is crucial in your recovery journey.

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