Improving Range of Motion After Old Elbow and Wrist Fractures

Post-fracture surgery

Hello Doctor, about 15 years ago, I suffered a comminuted fracture of the elbow and a wrist fracture from a fall during sports.
I had metal pins inserted initially, which were removed a few months later.
However, after rehabilitation, the range of motion in my hand is only about half of what is considered normal.
As a child, my parents did not allow any aggressive treatments, so I had to accept this condition.
I would like to know if there are any current treatments available that could help improve my condition and restore my hand's function to a state closer to normal.
This has been a significant concern for me for many years.
Thank you for your assistance.

Anthony, 30~39 year old female. Ask Date: 2022/05/11

Dr. Chen Bochen reply Orthopedics

Hello, I recommend that you visit a medical center to see a specialist in orthopedics and hand surgery.
I suggest Dr.
Chen Hsin-Chuan from Changhua Show Chwan Hospital.
I have several patients with similar conditions who have been successfully treated by Dr.
Chen.
Wishing you a speedy recovery!

Reply Date: 2022/05/11

More Info

Improving range of motion after old elbow and wrist fractures can be a challenging process, especially when significant injuries like comminuted fractures have occurred. Given your history of elbow and wrist fractures from a fall 15 years ago, it is understandable that you are seeking ways to enhance your functional mobility and overall quality of life.

Firstly, it is essential to acknowledge that the healing process after fractures can vary significantly from person to person. Factors such as the severity of the fracture, the type of surgical intervention, and the rehabilitation process all play crucial roles in determining the final outcome. In your case, it appears that despite undergoing rehabilitation, you have not regained full range of motion, particularly in terms of forearm supination and pronation.

Here are several approaches that may help you improve your range of motion:
1. Physical Therapy: Engaging with a skilled physical therapist who specializes in hand and upper extremity rehabilitation can be invaluable. They can provide tailored exercises that focus on stretching and strengthening the muscles around your elbow and wrist. Techniques such as manual therapy, which involves hands-on manipulation of the joints and soft tissues, may also be beneficial.

2. Home Exercise Program: Consistency is key in rehabilitation. A home exercise program that includes gentle stretching and strengthening exercises can help maintain and gradually improve your range of motion. Exercises like wrist flexor and extensor stretches, forearm pronation and supination movements, and elbow flexion and extension can be incorporated.

3. Occupational Therapy: An occupational therapist can help you with functional tasks and provide adaptive strategies to perform daily activities more efficiently. They can also introduce splinting techniques to help maintain or improve your range of motion.

4. Modalities: Various modalities such as heat therapy, cold therapy, ultrasound, and electrical stimulation can aid in reducing pain and inflammation, which may facilitate better movement. Discuss with your therapist which modalities might be appropriate for your situation.

5. Aquatic Therapy: Exercising in water can reduce the stress on your joints while allowing for a greater range of motion. The buoyancy of water can help you perform movements that may be difficult on land.

6. Gradual Progression: It’s important to set realistic goals and gradually increase the intensity and complexity of your exercises. Avoid pushing yourself too hard, as this can lead to setbacks.

7. Surgical Options: In some cases, if conservative measures do not yield satisfactory results, surgical options such as arthroscopy or tendon transfers may be considered. These procedures can help improve joint function and range of motion, but they come with their own risks and recovery times.

8. Alternative Therapies: Some individuals find relief and improvement through alternative therapies such as acupuncture or massage therapy. While scientific evidence may vary, these therapies can provide additional support in managing pain and improving mobility.

9. Mind-Body Techniques: Incorporating techniques such as yoga or tai chi can enhance flexibility and promote relaxation, which may indirectly improve your range of motion by reducing muscle tension.

10. Patience and Persistence: Recovery from significant injuries can be a long process. It’s crucial to remain patient and persistent in your efforts. Celebrate small improvements and stay motivated by setting achievable goals.

In conclusion, while the journey to regain full range of motion after old fractures can be complex, there are various strategies you can employ to improve your situation. Collaborating with healthcare professionals, maintaining a consistent exercise routine, and exploring various therapeutic options can significantly enhance your chances of achieving a better functional outcome. Remember, it’s never too late to seek help and work towards improving your quality of life.

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