Struggling to Open Hand After Wrist Fracture Surgery: Causes and Solutions

After a fracture, the hand is unable to open and lacks strength?

I underwent surgery for a fracture of the radius and ulna, during which two metal plates and one screw were inserted.
It has now been a month and a half, and I have been actively participating in rehabilitation.
Most of my functions have nearly returned to normal, except for the area between my fingers and palm, which still lacks strength.
However, I can lift my wrist.
When I consulted my doctor, he mentioned that he was unsure of the cause, suggesting it might be due to damage to the joint capsule from the car accident, which could have affected the nerves below.
He recommended that I undergo an electromyography (EMG) test.

Leo, 20~29 year old female. Ask Date: 2022/08/20

Dr. Zhan Xian reply Orthopedics

Please visit the orthopedic outpatient clinic for an examination.
Thank you.

Reply Date: 2022/08/20

More Info

After undergoing wrist fracture surgery involving the radius and ulna, it is not uncommon to experience difficulties in regaining full hand function, particularly in opening the hand. This situation can be attributed to several factors, including the nature of the injury, surgical intervention, and the rehabilitation process.

Causes of Difficulty in Opening the Hand
1. Joint Stiffness: Following a fracture and subsequent surgery, joint stiffness is a common issue. The immobilization of the wrist and hand during the healing process can lead to a decrease in range of motion. This stiffness can make it challenging to fully open the hand.

2. Soft Tissue Injury: If the joint capsule or surrounding soft tissues were injured during the accident, this could lead to adhesions or scar tissue formation, which can restrict movement. The injury to the joint capsule can also affect the overall mobility of the wrist and hand.

3. Nerve Injury: As your doctor mentioned, if the nerves in the wrist area were damaged during the accident, this could lead to weakness or loss of function in the hand. Nerve injuries can result in altered sensation and motor control, making it difficult to perform certain movements, including opening the hand.

4. Muscle Weakness: After surgery, the muscles that control hand movements may weaken due to disuse. Even if you are actively participating in rehabilitation, it may take time for these muscles to regain strength and coordination.

Solutions and Recommendations
1. Continued Rehabilitation: It is crucial to continue with physical therapy. A physical therapist can provide targeted exercises to improve range of motion, strengthen the muscles, and enhance overall hand function. They may use techniques such as manual therapy, stretching, and strengthening exercises tailored to your specific needs.

2. Occupational Therapy: In addition to physical therapy, occupational therapy can be beneficial. An occupational therapist can help you with functional tasks and provide adaptive techniques to improve your ability to open your hand and perform daily activities.

3. Nerve Conduction Studies: Since your doctor recommended an electromyography (EMG) test, it is essential to follow through with this. The EMG can help determine if there is any nerve damage and the extent of it. Understanding the status of your nerves can guide further treatment options.

4. Pain Management: If you are experiencing pain during rehabilitation, it can hinder your progress. Discuss pain management strategies with your healthcare provider. This may include medications, ice therapy, or other modalities to alleviate discomfort.

5. Gradual Progression: Be patient with your recovery. It is essential to set realistic goals and gradually work towards them. Celebrate small victories in your rehabilitation journey, as progress can sometimes be slow.

6. Consultation with Specialists: If you continue to have difficulties, consider seeking a second opinion from a hand specialist or an orthopedic surgeon who specializes in wrist injuries. They may provide additional insights or treatment options, including potential surgical interventions if necessary.

Conclusion
In summary, the challenges you are facing in opening your hand after wrist fracture surgery can stem from various factors, including joint stiffness, soft tissue injury, nerve damage, and muscle weakness. Continued rehabilitation, targeted therapy, and possibly further diagnostic testing will be crucial in addressing these issues. Remember to communicate openly with your healthcare providers about your concerns and progress, as they can offer the best guidance tailored to your situation. Your recovery journey may take time, but with persistence and the right support, you can work towards regaining full function of your hand.

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