Elbow and Wrist Injuries: A Comprehensive Guide

Elbow and wrist questions?

After being hit by a motorcycle while riding, I experienced pain in my hand and injuries to my leg.
I went to a Western medicine clinic where I received medication and a tetanus shot.
They advised me to ice my hand at home and prescribed some medications.
However, after icing my hand until the evening, it was still very painful and I couldn't lift it.
Later, I went to a traditional Chinese medicine hospital and discovered that I had a dislocated elbow and wrist injury.
The dislocated elbow was reset, and the next day I was able to lift and bend it.
I continued treatment for about a month, but my wrist still couldn't move smoothly.
Using chopsticks was awkward and painful, and I felt pain in the muscles connecting the bones of my thumb and little finger when lifting my hand.
I couldn't wring a towel, turn a doorknob, or scoop water.
Eventually, I had an X-ray of my wrist, which showed a fracture connecting the little finger to the wrist bones.
However, I was skeptical since I had already been treated for over a month.
I then went to another clinic, and they reviewed the X-ray and said there was no fracture, but rather pain in the periosteum of the bone.
Initially, my hand had no strength, but it has improved somewhat, although I still can't lift anything too heavy; I can't even lift a bowl.
It's been over 50 days, and my hand still isn't healed, which worries me.
Due to recent SARS concerns, I haven't dared to go to a large hospital, so I'm unsure if my elbow and wrist injuries are serious.
When I type on the computer, I experience some pain in my hand and elbow, and I can't use the mouse for too long.
I'm worried because I need to work on the computer, so I've been using one-finger typing with my left hand, which is quite difficult.

angela, 20~29 year old female. Ask Date: 2003/05/19

Dr. Shi Guozheng reply Orthopedics

Based on your description, it is possible that the fifth metacarpal bone in your hand is injured or fractured.
Generally, the healing time for this type of fracture is about two to three months, after which function will gradually return.
Before full recovery, you can soak your hand in warm water and perform some wrist exercises to slowly increase wrist strength.
If there is no improvement, you should consult a physician.

Reply Date: 2003/05/19

More Info

Injuries to the elbow and wrist can be quite complex, especially following trauma such as a motorcycle accident. Your symptoms suggest that you may be dealing with multiple issues, including a dislocated elbow and potential wrist injuries. Understanding these injuries and their implications is crucial for recovery.

Elbow Injuries
The elbow is a hinge joint that allows for flexion and extension, as well as some rotation. Dislocations, like the one you experienced, occur when the bones of the joint are forced out of their normal position. This can lead to significant pain, swelling, and limited range of motion. After a dislocation is reduced (put back into place), it is common to experience stiffness and weakness in the joint.
In your case, it seems that after the dislocation was treated, you regained some range of motion, but you still experience pain and difficulty with certain movements. This could be due to soft tissue injuries, such as ligament sprains or muscle strains, which are common after dislocations. The pain you feel when lifting your arm or performing specific tasks may indicate that the surrounding muscles and ligaments are still healing.

Wrist Injuries
Wrist injuries can vary widely, from sprains and strains to fractures. The fact that you have difficulty rotating your wrist and experience pain when using utensils suggests that there may be an underlying issue, such as a ligament injury or a fracture that may not have been initially detected.
The x-ray results indicating a possible fracture in the wrist area, particularly near the little finger, should be taken seriously. Even if a fracture is not present, the pain could be due to inflammation of the wrist joint or surrounding soft tissues, which can occur after trauma. The pain you experience when attempting to perform tasks like wringing out a towel or turning a doorknob could be a sign of tendonitis or tenosynovitis, conditions that involve inflammation of the tendons and their sheaths.

Recovery and Treatment
Given that you have been experiencing symptoms for over 50 days, it is essential to continue monitoring your condition. Here are some steps you can take:
1. Follow-Up Care: Regular follow-ups with a healthcare provider are crucial. If you are not seeing improvement, consider seeking a second opinion from an orthopedic specialist who can provide a thorough evaluation and possibly advanced imaging (like an MRI) to assess soft tissue injuries.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to improve strength, flexibility, and range of motion in both your elbow and wrist. They can also help manage pain through modalities such as ultrasound or electrical stimulation.

3. Pain Management: Over-the-counter pain relievers like acetaminophen or NSAIDs (ibuprofen) can help manage pain and inflammation. However, consult with your healthcare provider before starting any medication.

4. Activity Modification: Since you rely on your hands for computer work, consider ergonomic adjustments to your workspace. Use voice recognition software or ergonomic tools to reduce strain on your wrist and elbow.

5. Rest and Ice: Continue to rest your arm and apply ice to reduce swelling and pain. Avoid activities that exacerbate your symptoms.

6. Gradual Return to Activity: As your pain decreases and strength improves, gradually return to your normal activities. Avoid heavy lifting or repetitive motions until you are cleared by a healthcare professional.

Conclusion
Injuries to the elbow and wrist can take time to heal, especially after significant trauma. It is essential to remain vigilant about your symptoms and seek appropriate care. With the right treatment and rehabilitation, many individuals can regain full function of their elbow and wrist. However, if you continue to experience pain or limitations, further evaluation may be necessary to rule out any serious underlying issues. Remember, your health and recovery should always be your top priority.

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