Ulnar Fractures: Recovery, Surgery, and Rehabilitation Insights - Orthopedics

Ulnar fracture

---

Hello Director Zhang,
I suffered a ulnar fracture in my left hand due to a fight at the beginning of April.
A friend took me to the emergency room, where the doctor performed an X-ray and applied a cast, instructing me to return for a follow-up in six weeks.
In early May, during my follow-up, another X-ray was taken, and the doctor indicated that the bone was healing.
The emergency room nurse was instructed to wrap the cast tighter, and I was told to return in two weeks.
On May 22, I visited the same hospital but saw a different doctor.
After another X-ray, he surprisingly stated that the bone had not healed and recommended surgery! I immediately arranged for hospitalization and underwent surgery, during which five metal screws and a plate were inserted.
I was discharged two days later.

On May 25, my family transferred me to a larger hospital for further evaluation, where another X-ray was performed.
The attending physician remarked that it was inappropriate to place screws at the fracture site, as this could slow down the healing process.
Typically, screws are not inserted in this manner.
He recommended keeping the cast on for a month and starting rehabilitation for my elbow and fingers.
He mentioned that the screws would need to remain for about a year before removal.
Since then, I have been under the care of this hospital, with monthly follow-ups.

During my follow-up on June 18, the doctor cut the cast in half, stating that I could occasionally remove it to allow the area to breathe, as my hand was showing signs of allergy from prolonged casting.
Rehabilitation for my fingers was advised, but I was cautioned against moving my wrist to avoid damaging the plate.
On July 16, the doctor switched my cast to a lighter resin type for a month.
During my follow-up on August 12, the doctor said the cast could be removed, and I could start slowly moving my wrist for rehabilitation.
He advised me to purchase an extended wrist brace to protect the fracture site while working and riding a motorcycle, and to return in three months.
I would like to ask you, Director Zhang:
1.
Does inserting screws at the fracture site truly affect the healing speed of the bone?
2.
Why is it that my screws cannot be removed for a year? A friend of mine had a toe fracture and underwent surgery with screws, but he fully healed in less than a month and had his screws removed.
Is there a correlation between the size of the bone and the healing time? Do thicker bones take longer to heal while thinner bones heal faster?
3.
I originally worked in a factory doing machining, which required lifting heavy objects and molds.
However, my left hand cannot exert force to lift heavy items, making it difficult to find factory jobs that require lifting.
Is there any way to expedite the recovery of my left hand to its pre-injury state and regain full strength? For example, should I start with light dumbbells and gradually train to adapt my left hand to lifting weights?
4.
Currently, the range of motion in my left wrist is limited.
I can only bend it upwards to about 20-30 degrees and downwards to about 20 degrees before I cannot bend it further.
Attempting to bend it more feels weak, as if something is blocking it.
Is this due to the wrist being unused for half a year, leading to muscle weakness, preventing it from bending to 90 degrees like my right hand? Are there any methods to relax the muscles and nerves in my wrist to help it bend to 90 degrees quickly, such as using heat therapy or muscle pain relief sprays?

---

Liu Ding, 20~29 year old female. Ask Date: 2009/09/23