Recovery Timeline and Concerns After Wrist Fracture Surgery

Q: Recovery Timeline and Concerns After Wrist Fracture Surgery

Hello： Each person's fracture situation is different, and everyone's needs vary. <br>As a young person who hopes to perform weight-bearing activities in the future, your situation is naturally different from that of an elderly person who primarily seeks pain relief and sufficient

excuse me?

Hello, I had a car accident in January and suffered an open and comminuted fracture of my left wrist.
Both my ulna and radius were broken, and I had six steel pins inserted, which are external pins that are placed on the flesh.
It has been over three months now.
How long will it take before the pins can be removed? Why is it taking so long? After the pins are removed, how long will it take for the wound to heal? How long will it be before I can use my injured hand for activities like brushing my teeth, washing my face, or picking things up? Can I dance again? I am a dance student, and I'm worried that if I dance, my hand might break again.
How long will rehabilitation take before my hand can regain normal function? How long will it be before I can perform weight-bearing activities with my hand, such as push-ups? Will my hand be less flexible in the future? I am very concerned about my hand's future mobility.
My primary physician said that I did not injure my nerves or ligaments, so it should be fine.
However, when I visited another doctor (not the one who performed my surgery), he reviewed my X-rays and mentioned that due to the fragmentation, my hand might not regain full mobility.
Why do these two orthopedic surgeons have differing opinions? Since I am a dancer, I am particularly worried and afraid that my hand will become useless.
Thank you.

Haha, 20~29 year old female. Ask Date: 2009/04/25

Dr. Li Wenlin reply Orthopedics

Hello: Each person's fracture situation is different, and everyone's needs vary.
As a young person who hopes to perform weight-bearing activities in the future, your situation is naturally different from that of an elderly person who primarily seeks pain relief and sufficient functionality for daily living.
Therefore, it is essential to fully cooperate with your attending physician, as they understand your condition best.
Generally speaking, for distal radius and ulnar fractures, external fixation should remain in place until there is initial stability (approximately six to eight weeks, and sometimes longer than three months) before it can be removed.
Prolonged use of external fixation can lead to joint stiffness, so your physician will determine the optimal timing for removal based on findings during follow-up visits.
As for the wounds after the removal of external fixation, they are typically just a few small holes and usually heal within three to four days, or up to a week at most, so there is no need to worry about the removal site.
Regarding activities like brushing your teeth, washing your face, or dancing, please consult your attending physician.
If necessary, ask them to refer you to a rehabilitation specialist they know well.
Collaborating with both the rehabilitation physician and therapists can yield better results.
In summary, just cooperate with your physician! Wishing you all the best!

Reply Date: 2009/04/25

More Info

Recovering from a wrist fracture, especially one that is open and comminuted, can be a complex and lengthy process. Given your situation, where both the ulna and radius were fractured and treated with six external pins, it is understandable that you have many concerns regarding your recovery timeline and the potential for long-term functionality of your wrist.

Recovery Timeline
Typically, the healing process for wrist fractures can take anywhere from 6 to 12 weeks, depending on the severity of the fracture, the type of surgical intervention, and individual healing factors. Since you mentioned that it has been over three months since your surgery, you are likely in the later stages of the initial healing phase. However, the presence of comminuted fractures can complicate this timeline, as they often require a longer period for the bones to heal adequately.

Pin Removal and Healing
The decision to remove the pins is usually based on the healing progress observed through follow-up X-rays and clinical evaluations. If the bones are healing well and there are no signs of complications such as infection or improper alignment, your surgeon may consider removing the pins. This process can take anywhere from 6 weeks to several months post-surgery, depending on your specific healing progress.

Once the pins are removed, the surgical site will need time to heal. Generally, the incision site can take about 2 to 4 weeks to heal sufficiently, but this can vary based on individual factors such as age, overall health, and adherence to post-operative care instructions.

Functional Recovery
In terms of regaining functionality, you may start performing light activities with your injured hand, such as brushing your teeth or washing your face, once the pain subsides and your doctor gives you the green light. However, it is crucial to avoid any heavy lifting or strenuous activities until you have fully healed.

As for dancing, it is essential to approach this activity cautiously. While you may feel eager to return to dancing, it is advisable to wait until you have regained sufficient strength and range of motion in your wrist. Engaging in high-impact activities too soon can risk re-injury, especially with a history of comminuted fractures.

Rehabilitation
Rehabilitation is a critical component of your recovery. Physical therapy typically begins after the initial healing phase, focusing on restoring range of motion, strength, and functionality. The duration of rehabilitation can vary widely but often lasts several weeks to months. Your therapist will tailor a program to your specific needs, gradually increasing the intensity of exercises as your wrist heals.

Concerns About Mobility
Your concern about the potential for long-term stiffness or lack of mobility in your wrist is valid, especially given the nature of your injury. However, since your primary surgeon indicated that there was no nerve or ligament damage, this is a positive sign for your recovery. Stiffness can occur after any fracture, particularly in complex cases, but with diligent rehabilitation and adherence to your therapist's guidance, many patients regain full or near-full functionality.

Divergent Opinions
Regarding the differing opinions from the two orthopedic surgeons, it is not uncommon for medical professionals to have varying perspectives based on their experiences and interpretations of imaging studies. The first surgeon may be optimistic about your recovery due to the absence of nerve or ligament damage, while the second may be more cautious given the complexity of your fracture. It is essential to maintain open communication with your primary surgeon and express your concerns, as they are most familiar with your specific case.

Conclusion
In summary, while the recovery from your wrist fracture may feel slow and fraught with uncertainty, it is essential to remain patient and committed to your rehabilitation. Follow your surgeon's advice, engage actively in physical therapy, and gradually reintroduce activities as your wrist heals. With time and effort, many patients can return to their previous levels of activity, including dancing. Always consult your healthcare provider before making decisions about your recovery to ensure the best outcomes.

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