Is My Home Rehabilitation After Arm Fracture Sufficient?

Q: Is My Home Rehabilitation After Arm Fracture Sufficient?

Ms. <br>Huang： Hello, based on your description, it seems that you are diligently working on your rehabilitation and your range of motion is improving. <br>If possible, I recommend that you take some time to see a rehabilitation physician, and also have a physical therapist evalu

Is this rehabilitation sufficient after a fracture surgery?

Hello Doctor, on November 26, I suffered an open comminuted fracture of the distal humerus in my left arm due to a car accident.
On the day of the injury, I underwent my first surgery for debridement.
Nine days later, the swelling had decreased, and I had a second surgery where two steel plates were used for fixation.
The incision near my elbow is about 16 cm long.
Two days ago (on the 23rd day post-injury), I returned for a follow-up appointment to have the stitches removed.
The swelling has mostly subsided, but the area around my elbow feels very stiff.
My attending physician advised me to perform rehabilitation exercises at home for one month and to return for a follow-up in mid-January.
If the range of motion for bending and straightening is still not satisfactory, I will need to see a physical therapist.
Currently, I am doing self-rehabilitation for my left arm three times a day (morning, noon, and evening), alternating between exercises A and B for one hour each, followed by exercise C for one hour, totaling about six hours a day.

A: Stretching and massage, followed by exercise B: resting my left arm on my left thigh, using my right hand to grasp my left wrist, and pushing upwards with both hands while applying downward pressure with my shoulder.
If I get tired, I return to A.

C: Wearing a splint (approximately at a 30-degree angle; all angles are estimated relative to the horizontal plane and forearm).
Before practicing straightening, I could bend my arm about 60 degrees and straighten it about 45 degrees.
After practicing, I can bend it 110-120 degrees and straighten it 20-30 degrees.

I am really afraid that I might be doing the rehabilitation incorrectly or insufficiently, and I may still need to consult a physical therapist.
I would like to ask you, Doctor, if my current rehabilitation method is appropriate.
Thank you!

Huang's, 30~39 year old female. Ask Date: 2012/12/19

Dr. Li Weiqiang reply Rehabilitation

Ms.
Huang: Hello, based on your description, it seems that you are diligently working on your rehabilitation and your range of motion is improving.
If possible, I recommend that you take some time to see a rehabilitation physician, and also have a physical therapist evaluate your movements to ensure they are appropriate and to provide guidance on new exercises.
If you are near Taoyuan Hospital, you are welcome to visit my clinic, and I would be happy to provide you with services.
Thank you! Wishing you safety and health.
Sincerely, Dr.
Li Wei-Chiang, Director of the Rehabilitation Department, Taoyuan Hospital, Department of Health.

Reply Date: 2012/12/19

More Info

It sounds like you are going through a challenging recovery process after your arm fracture, and it's great that you are taking an active role in your rehabilitation. Based on your description, it seems you are following a structured home rehabilitation program, which is essential for recovery. However, let’s break down your current rehabilitation approach and see if there are any adjustments or additional considerations that could enhance your recovery.

Current Rehabilitation Approach
1. Frequency and Duration: You mentioned that you are doing rehabilitation three times a day, with each session lasting about six hours in total. This frequency is commendable, but it’s crucial to ensure that you are not overexerting yourself. Quality is often more important than quantity in rehabilitation.
2. Exercises:
- Stretching and Massage (A): This is a good start as it helps improve blood circulation and flexibility. Make sure to be gentle and avoid any movements that cause sharp pain.

- Strengthening (B): The exercise where you use your right hand to assist your left hand in lifting is beneficial. It’s important to maintain a balance between pushing your limits and not overdoing it, which could lead to further injury.

- Splinting (C): Wearing a splint at a 30-degree angle is appropriate for maintaining some stability while allowing for movement. However, ensure that the splint is not too restrictive, as this could impede your recovery.

Progress and Concerns
You noted that your current range of motion allows for bending about 110-120 degrees and straightening to about 20-30 degrees. While progress is being made, the goal is to achieve a full range of motion over time. It’s important to continue working on both flexion and extension, as both are crucial for functional recovery.

Recommendations
1. Consult a Physical Therapist: While your home rehabilitation is a great start, working with a physical therapist can provide you with tailored exercises that are specific to your recovery needs. They can also ensure that you are performing exercises correctly to avoid any potential setbacks.

2. Monitor Pain Levels: Pay attention to your pain levels during and after exercises. If you experience significant pain, it may be a sign to modify your approach. Pain should not be a constant companion during rehabilitation; it should be manageable and not prevent you from performing your exercises.

3. Incorporate Functional Movements: As you progress, try to incorporate functional movements that mimic daily activities. This could include reaching for objects, lifting light weights, or even practicing activities that require coordination.

4. Nutrition and Hydration: Ensure you are eating a balanced diet rich in calcium and vitamin D to support bone healing. Staying hydrated is also essential for overall recovery.

5. Patience and Consistency: Recovery from a fracture, especially a complex one like yours, takes time. Be patient with yourself and stay consistent with your rehabilitation efforts.

Conclusion
Your proactive approach to rehabilitation is commendable, and it seems you are on the right track. However, incorporating professional guidance from a physical therapist could significantly enhance your recovery process. They can provide you with the necessary adjustments and ensure that your rehabilitation is effective and safe. Remember, recovery is a journey, and it’s important to celebrate the small victories along the way. Keep up the good work, and best wishes for your continued recovery!

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