Post-Surgery Wrist Weakness in Children: What Parents Should Know

Q: Post-Surgery Wrist Weakness in Children: What Parents Should Know

Hello： This phenomenon can be addressed by collaborating with a rehabilitation physician and an orthopedic attending physician, while continuing to follow up with orthopedics. <br>If there are any issues, the physician will provide further recommendations. <br>Please communicate

After the second surgery, I am unable to lift my wrist?

Hello Doctor: Our child, who is eight years old, suffered a humeral fracture while running at school on May 13.
He underwent surgery the same day to implant a steel pin, and his wrist was normal after the operation.
However, during a follow-up visit on June 30, we discovered that the steel pin had shifted, leading to a second surgery on July 8.
After this surgery, we noticed weakness in his wrist; he can bend his thumb, but it is weak.
His index finger can bend normally and has strength, while his middle, ring, and little fingers can bend but with strength greater than the thumb and less than the index finger.
The doctor mentioned that rehabilitation would help, but after a month and a half, there has been no improvement.
What should we do to help him? As parents, we are very worried! Thank you!

aders, 40~49 year old female. Ask Date: 2009/08/24

Dr. Li Wenlin reply Orthopedics

Hello: This phenomenon can be addressed by collaborating with a rehabilitation physician and an orthopedic attending physician, while continuing to follow up with orthopedics.
If there are any issues, the physician will provide further recommendations.
Please communicate frequently with your attending physician.
Most fractures in children can heal well, so there is no need to worry too much.
Wishing you a speedy recovery! Orthopedic Dr.
Li Wen-Lin

Reply Date: 2009/08/24

More Info

Post-surgery wrist weakness in children can be a concerning issue for parents, especially after a significant injury like a humeral fracture. It’s essential to understand the recovery process, the importance of rehabilitation, and how to support your child during this time.

Understanding the Situation
After your child's surgery for a humeral fracture, the presence of a steel pin is intended to stabilize the bone and facilitate healing. However, complications such as pin migration can necessitate additional surgeries, as you experienced. Following the second surgery, it’s not uncommon for children to exhibit weakness in the wrist and fingers due to several factors:
1. Muscle Atrophy: After surgery, especially if the arm was immobilized, the muscles around the wrist and hand may weaken due to disuse. This atrophy can lead to decreased strength and functionality.

2. Nerve Involvement: Depending on the nature of the injury and the surgical procedure, there may be temporary nerve irritation or damage that can affect strength and movement in the fingers.

3. Pain and Discomfort: If your child is experiencing pain, even mild, it can lead to reluctance to use the affected hand fully, further contributing to weakness.

4. Psychological Factors: Children may also have anxiety about using the injured limb, which can inhibit their willingness to engage in rehabilitation exercises.

Rehabilitation and Recovery
Rehabilitation is crucial for recovery after surgery. Here are some steps you can take to support your child:
1. Follow-Up with a Specialist: Ensure that you have regular follow-ups with an orthopedic specialist or a pediatric rehabilitation physician. They can assess the healing process and adjust rehabilitation strategies as needed.

2. Physical Therapy: If not already initiated, consider enrolling your child in a physical therapy program. A physical therapist can provide tailored exercises to strengthen the wrist and fingers, improve range of motion, and address any specific weaknesses.

3. Home Exercises: Encourage your child to perform gentle exercises at home, such as:
- Wrist Flexion and Extension: Moving the wrist up and down.

- Finger Flexion: Bending and straightening each finger.

- Grip Strengthening: Using a soft ball or putty to squeeze can help improve grip strength.

4. Encouragement and Support: Provide emotional support and encouragement. Celebrate small victories in their recovery, and reassure them that progress may be slow but is still progress.

5. Pain Management: If your child is experiencing pain, discuss pain management options with your doctor. Proper pain control can help them engage more fully in rehabilitation exercises.

6. Nutrition: Ensure your child is eating a balanced diet rich in calcium and vitamin D to support bone health and recovery.

Monitoring Progress
It’s essential to monitor your child’s progress closely. If there is no improvement after a reasonable period, or if you notice any new symptoms (such as increased pain, swelling, or changes in sensation), contact your healthcare provider. They may recommend further imaging studies or adjustments to the rehabilitation plan.

Conclusion
As a parent, it’s natural to feel worried about your child’s recovery after surgery. By actively participating in their rehabilitation process, maintaining open communication with healthcare providers, and providing emotional support, you can help your child regain strength and confidence in their wrist and hand. Remember, recovery can take time, and patience is key. If you have any further questions or concerns, don’t hesitate to reach out to your child’s healthcare team for guidance.

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