Post-Surgery Symptoms: Wrist Fracture and Carpal Tunnel Syndrome

Wrist - Radial Fracture

Hello Dr.
Chen,
I fell in early August and sustained a distal radius fracture near my wrist.
I underwent surgery on August 8, where internal fixation with metal pins was performed.
After the surgery, I seem to be experiencing symptoms of carpal tunnel syndrome, with numbness in my index, middle, and ring fingers.
Is this a normal occurrence after surgery, and how long is it expected to last? Thank you for your response.

Hsu Yong, 30~39 year old female. Ask Date: 2005/08/31

Dr. Chen Xingyuan reply Orthopedics

Dear Mr.
Hsu,
In cases of distal radius fractures, the fragments of the bone can sometimes impinge upon or stretch the median nerve, leading to hand numbness similar to carpal tunnel syndrome.
As long as the fracture site is properly realigned and stabilized, irritation of the median nerve by the bone fragments can be avoided, and most symptoms will gradually improve.
The recovery time varies depending on the severity of the injury; generally, significant recovery can be expected within three months.
If your symptoms do not show daily improvement, it is advisable to consult your attending physician for further evaluation and examination.
Wishing you health and safety!
Sincerely,
Dr.
Chen

Reply Date: 2005/08/31

More Info

After a wrist fracture surgery, particularly one involving the distal radius, it is not uncommon for patients to experience symptoms that may resemble carpal tunnel syndrome (CTS). This condition occurs when the median nerve, which runs through the carpal tunnel in the wrist, becomes compressed. The symptoms you are describing—numbness in the index, middle, and ring fingers—are classic signs of CTS.

In your case, the numbness you are experiencing could be attributed to several factors related to your surgery and recovery process. Firstly, swelling in the wrist following surgery can lead to increased pressure within the carpal tunnel, exacerbating symptoms of CTS. Additionally, the surgical procedure itself may have caused some temporary irritation or compression of the median nerve, especially if there was significant swelling or if the surgical approach involved manipulation of the surrounding tissues.

Typically, post-surgical swelling can last for several weeks, and the duration of numbness or tingling can vary from person to person. In many cases, if the symptoms are indeed related to swelling, they may begin to improve within a few weeks as the swelling subsides. However, if the symptoms persist beyond a few weeks or worsen, it is crucial to follow up with your orthopedic surgeon or a hand specialist. They may recommend further evaluation, which could include imaging studies or nerve conduction studies to assess the function of the median nerve.

In the meantime, there are several strategies you can employ to help alleviate your symptoms. Elevating your wrist above heart level can help reduce swelling. Gentle range-of-motion exercises, as advised by your physical therapist, can also promote circulation and reduce stiffness. Additionally, wearing a wrist splint, especially at night, can help keep your wrist in a neutral position and relieve pressure on the median nerve.

If conservative measures do not lead to improvement, your physician may discuss other options, such as corticosteroid injections to reduce inflammation or, in more severe cases, surgical intervention to relieve the pressure on the median nerve.

In summary, while some degree of numbness and discomfort can be expected after wrist surgery, it is essential to monitor your symptoms closely. If they do not improve within a reasonable timeframe or if they worsen, do not hesitate to seek further medical advice. Early intervention can often lead to better outcomes and a quicker return to normal function.

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