Post-Surgery Recovery: Managing Stiffness After First Metacarpal Fracture - Rehabilitation

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Post-surgery recovery, especially after a first metacarpal fracture with dislocation, can be challenging, particularly when stiffness occurs in the thumb's metacarpophalangeal (MCP) joint. The use of titanium plates during surgery is common for stabilizing fractures, but immobilization following surgery can lead to stiffness and reduced range of motion.


Understanding Stiffness After Surgery
Stiffness in the MCP joint after surgery is often due to a combination of factors, including:
1. Immobilization: After surgery, the affected area is usually immobilized to allow for proper healing. While this is necessary, it can lead to joint stiffness and muscle atrophy due to lack of movement.

2. Scar Tissue Formation: The healing process can lead to the formation of scar tissue around the joint, which can restrict movement.

3. Pain and Discomfort: Post-operative pain can also inhibit movement, leading to a cycle of stiffness and discomfort.


Recovery Timeline
Typically, after a fracture and surgical intervention, it can take several weeks to months for full range of motion to return. The timeline varies based on individual healing rates, the extent of the injury, and adherence to rehabilitation protocols. In your case, since it has been one month post-surgery, it is not uncommon to experience stiffness, but it is crucial to begin gentle rehabilitation to regain mobility.


Self-Rehabilitation Strategies
Here are some strategies you can implement to manage stiffness and promote recovery:
1. Gentle Range of Motion Exercises: Start with passive range of motion exercises. Use your other hand to gently move the thumb through its range of motion. This can help reduce stiffness without putting too much strain on the healing joint.

2. Active Range of Motion Exercises: Once you feel comfortable, begin active exercises. Try to bend and straighten your thumb as much as possible. You can also practice pinching and gripping exercises using soft objects like a stress ball or putty.

3. Heat Therapy: Applying heat to the affected area before exercises can help relax the muscles and improve blood flow, making it easier to move the joint.

4. Cold Therapy: After exercises, applying ice can help reduce any swelling and discomfort that may arise.

5. Gradual Increase in Activity: As you progress, gradually increase the intensity and duration of your exercises. Aim for short sessions multiple times a day rather than long sessions that may lead to fatigue.

6. Consult a Physical Therapist: If possible, working with a physical therapist can provide you with a tailored rehabilitation program. They can guide you through specific exercises and techniques to improve your range of motion and strength while ensuring you do not overexert yourself.


When to Seek Further Help
If after a few weeks of consistent rehabilitation you do not notice any improvement in your thumb's mobility, or if you experience significant pain, it is essential to consult your orthopedic surgeon or a hand specialist. They may recommend imaging studies to assess the healing process and determine if further intervention is necessary.


Conclusion
In summary, stiffness after a first metacarpal fracture is a common issue that can be managed with a combination of gentle exercises, heat and cold therapy, and possibly professional guidance. It is crucial to listen to your body and progress at a pace that feels comfortable while ensuring that you are actively working towards regaining full function of your thumb. With patience and consistent effort, you can improve your range of motion and return to your daily activities.