Right Hand Joint Issues After Fracture: Rehabilitation or Surgery? - Orthopedics

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Hello! It sounds like you've been through quite a challenging experience with your right hand fracture and subsequent rehabilitation. Given the complexity of your situation, let's break down your concerns regarding the ongoing issues with your right hand joint after the fracture, and discuss whether further rehabilitation or surgery might be necessary.

First, it's important to understand that fractures, especially those involving the ulna and radius near the wrist, can lead to complications such as malunion (healing in an incorrect position) or nonunion (failure to heal). The fact that you have a 2mm discrepancy between the ulna and radius is significant, but as your doctor mentioned, surgery is typically considered when the discrepancy exceeds 5mm. This suggests that your current condition may still be manageable with conservative treatment, including physical therapy.

However, your ongoing pain during activities like push-ups indicates that there may be underlying issues that need to be addressed. Pain during movement can be a sign of several things, including:
1. Muscle Imbalance: After a fracture, it's common for certain muscles to weaken or become tight, leading to imbalances that can cause pain during physical activities. This could be exacerbated by compensatory movements that you may have developed to avoid using your injured hand fully.

2. Joint Instability: If the joint is not stable due to the previous injury, it can lead to pain when performing weight-bearing exercises. The fact that you feel pain concentrated in one area of the wrist suggests that the joint may not be functioning optimally.

3. Tendon or Ligament Issues: Sometimes, the surrounding soft tissues can be affected by the fracture and may not have healed properly, leading to pain during certain movements.

Given these considerations, here are some recommendations:
1. Continue Rehabilitation: It would be beneficial to continue with your rehabilitation program, focusing on strengthening the muscles around the wrist and elbow. A physical therapist can help you develop a tailored program that addresses your specific weaknesses and pain points. They can also guide you on proper techniques to avoid further injury during exercises.

2. Pain Management: If the pain persists, consider discussing pain management strategies with your healthcare provider. This could include anti-inflammatory medications, ice therapy, or modifications to your exercise routine to avoid aggravating the pain.

3. Re-evaluate with Your Doctor: Since you have ongoing pain and functional limitations, it may be wise to schedule a follow-up appointment with your orthopedic surgeon or a hand specialist. They can assess your current condition, possibly order additional imaging if needed, and determine if there are any changes in your treatment plan that should be made.

4. Surgery Consideration: If conservative measures do not lead to improvement, and if your quality of life is significantly affected, discussing the possibility of corrective surgery may be warranted. Surgery can help realign the bones and restore function, but it also comes with risks and a recovery period that must be considered.

In summary, while your current situation may not necessitate immediate surgery, ongoing rehabilitation is crucial. Pay attention to your body's signals, and don't hesitate to seek further evaluation if your pain continues or worsens. Your goal should be to regain full function and minimize discomfort, and with the right approach, you can work towards achieving that. Best wishes for your recovery!