Post-Fracture Rehabilitation: Wrist Recovery After Surgery

Postoperative fracture of the radius and ulna?

Dear Doctor, I suffered a fracture of the distal radius and ulnar on December 20, underwent surgery on December 22, and was hospitalized for 5 days before being discharged.
During rehabilitation, I was only able to perform hand grip exercises initially.
After a week, I returned for a follow-up appointment, and the doctor advised me to start wrist flexion and extension exercises.
After another month and a week, I was instructed to begin wrist rotation exercises.

1.
Shouldn't rehabilitation begin as soon as possible after surgery, or is it necessary to gradually increase the range of motion due to specific circumstances?
2.
During rehabilitation, I feel a lot of tightness, and I hear a popping sound in my bones when I rotate my wrist.
Why is this happening? Thank you, Doctor, for your response.

Aj, 40~49 year old female. Ask Date: 2024/02/03

Dr. Shi Guozheng reply Orthopedics

After surgery, it is important to start wrist joint exercises as early as possible.
Additionally, the hand should perform fist clenching and opening movements to help loosen the finger joints.
Regular follow-up appointments are necessary to monitor the healing of the fracture.
If healing is progressing well, the intensity of rehabilitation can be increased.
It is normal for the bones to make sounds during this process.

Reply Date: 2024/02/03

More Info

Post-fracture rehabilitation is a critical aspect of recovery following wrist surgery, especially after a distal radius (尺骨) fracture. Your experience of having surgery on December 22 after a fall, followed by a structured rehabilitation program, is quite typical. Let's delve into your questions and concerns regarding the rehabilitation process.

1. Gradual Increase in Rehabilitation Activities: After surgery, the primary goal is to ensure that the surgical site heals properly while minimizing the risk of complications. In many cases, especially with fractures, the initial phase of rehabilitation focuses on protecting the healing bone and surrounding tissues. This often means starting with gentle movements and gradually increasing the range of motion and strength exercises as healing progresses. The timeline for rehabilitation can vary based on the type of fracture, the surgical technique used, and individual healing rates.
In your case, the progression from grip exercises to wrist flexion and extension, followed by rotation, is a common approach. This stepwise increase in activity helps to avoid overstressing the healing tissues, which could lead to complications such as re-fracture or delayed healing. It’s essential to follow your physician's or physical therapist's guidance closely, as they tailor the rehabilitation program to your specific needs and recovery status.

2. Tightness and Noises During Rehabilitation: Feeling tightness during rehabilitation exercises is a common experience, especially after a fracture. This tightness can be attributed to several factors, including swelling, muscle stiffness, and the formation of scar tissue around the surgical site. The sound of bones or joints clicking or popping during movement can also be normal, particularly if there are changes in the joint mechanics post-surgery. However, if the sounds are accompanied by pain or discomfort, it’s crucial to communicate this with your healthcare provider.

The tightness you feel may improve as you continue with your rehabilitation exercises. Consistent practice of the prescribed movements, along with modalities such as heat therapy, can help alleviate stiffness. Additionally, your physical therapist may incorporate manual therapy techniques to improve mobility and reduce tightness.

Additional Considerations for Recovery:
- Pain Management: It's important to manage any pain you experience during rehabilitation. If certain movements cause significant discomfort, it may be beneficial to modify those exercises or adjust the intensity. Always communicate with your therapist about your pain levels.

- Home Exercises: In addition to your therapy sessions, performing prescribed exercises at home can enhance recovery. Consistency is key, as regular movement helps maintain joint flexibility and muscle strength.

- Nutrition and Healing: Proper nutrition plays a vital role in bone healing. Ensure you are consuming a balanced diet rich in calcium and vitamin D, which are essential for bone health. Staying hydrated and maintaining a healthy lifestyle can also support your recovery.

- Follow-Up Appointments: Regular follow-ups with your orthopedic surgeon or physical therapist are crucial. They can assess your progress, make necessary adjustments to your rehabilitation plan, and ensure that your recovery is on track.

In conclusion, while the rehabilitation process may feel slow at times, it is designed to prioritize your safety and long-term recovery. Adhering to your rehabilitation program, maintaining open communication with your healthcare team, and being patient with your progress will ultimately lead to the best outcomes. If you have any concerns about your recovery or specific symptoms, do not hesitate to reach out to your healthcare provider for guidance.

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