Managing Post-Fracture Recovery: Tips for Preventing Arthritis After a Radial Head Injury

Radial head comminuted fracture (Mason type III)

Hello, Doctor.
I was in a car accident on November 26, resulting in a comminuted fracture of the left radial head.
The physician diagnosed it as a Mason Type III fracture, which required surgical intervention to insert a steel plate and seven screws for stabilization.
It has now been six weeks since the surgery.
During my last consultation, I asked the doctor about heterotopic ossification, and I appreciate the physician's response, which has greatly eased my mind.

During my six-week follow-up, the attending physician mentioned that the bone is healing well and that the internal fixation has not shifted.
I am grateful for your willingness to answer my questions, which has allowed me to navigate these past six weeks with more peace of mind.
However, I have been experiencing a sensation of catching in the radial joint during flexion and extension exercises, and occasionally, it feels like the bones are grinding against each other.
After consulting with my attending physician, I was informed that due to the severity of the fracture, approximately one-third of the cartilage in the radial head was lost due to the impact, resulting in an uneven joint surface, which may lead to symptoms of arthritis in the future.
I would like to seek your advice on a few questions:
1.
As a right-handed person working in accounting, I do not smoke or drink, and I have a habit of jogging daily.
If I take good care of my left hand by avoiding heavy lifting, strenuous pushing, and switching from jogging to cycling or using a stationary bike, while limiting the use of my left hand to activities like bathing, washing my face, driving, and eating, can I reduce the likelihood of developing arthritis within the next ten years?
2.
Since the original cartilage may not regenerate, what actions can I take to delay the onset of arthritis? Are there any treatments available to protect the remaining cartilage and slow its degeneration?
Thank you for your responses, as they help me understand certain realities and encourage me to accept what has happened.
I am focusing on aspects of my life that I can change, and your answers have made me braver.

A-Chang, 20~29 year old female. Ask Date: 2015/01/08

Dr. Shi Guozheng reply Orthopedics

Your maintenance methods may potentially delay the onset of arthritis.
Additionally, some suggest that taking glucosamine may improve conditions, as it can promote cartilage growth.
In the event that degenerative arthritis does occur, high-concentration platelet-rich plasma (PRP) injections can be used to treat or delay the progression of arthritis.

Reply Date: 2015/01/08

More Info

Managing post-fracture recovery, especially after a radial head injury, requires careful attention to both rehabilitation and preventive measures to minimize the risk of developing arthritis in the future. Given your situation, where you have sustained a Mason type III fracture of the radial head and have undergone surgical intervention with the insertion of a plate and screws, it is crucial to follow a structured approach to recovery.

1. Activity Modification and Joint Protection
You mentioned that you are a right-handed individual working in accounting and that you engage in regular exercise. To reduce the risk of arthritis developing in your left arm, it is wise to modify your activities. Avoiding heavy lifting and repetitive strain on the injured arm is essential. Transitioning from running to cycling or using a stationary bike is a good strategy, as it reduces the impact on your arm while still allowing you to maintain cardiovascular fitness.

In addition to avoiding heavy lifting, consider using ergonomic tools and supports that can help reduce strain on your left arm during daily activities. For instance, using a voice-to-text software for work can minimize the need for extensive typing, which can put stress on your wrist and elbow.

2. Rehabilitation Exercises
While it is important to avoid overusing your left arm, engaging in gentle range-of-motion exercises as advised by your physician is crucial. These exercises can help maintain joint mobility and prevent stiffness. It is essential to listen to your body and avoid pushing through pain, as this can lead to further injury.

Incorporating physical therapy into your recovery plan can also be beneficial. A physical therapist can provide tailored exercises that focus on strengthening the muscles around the joint, improving flexibility, and enhancing overall function. They can also guide you on how to perform exercises safely without exacerbating your condition.

3. Nutritional Support for Joint Health
Nutrition plays a significant role in joint health and recovery. Consuming a balanced diet rich in anti-inflammatory foods can help support your recovery and potentially slow down the progression of arthritis. Foods high in omega-3 fatty acids (such as salmon, walnuts, and flaxseeds), antioxidants (fruits and vegetables), and whole grains can be beneficial.

Additionally, some studies suggest that supplements like glucosamine and chondroitin may help in maintaining cartilage health, although results can vary. Always consult with your healthcare provider before starting any new supplements to ensure they are appropriate for your situation.

4. Monitoring Symptoms and Seeking Care
As you progress in your recovery, it is vital to monitor any symptoms that may indicate complications, such as increased pain, swelling, or decreased range of motion. If you experience persistent discomfort or changes in your joint function, do not hesitate to reach out to your healthcare provider. Early intervention can prevent further complications and help manage any emerging issues.

5. Long-Term Considerations
While it is difficult to predict the exact timeline for the onset of arthritis, maintaining a proactive approach to joint health can significantly influence your long-term outcomes. Regular follow-ups with your healthcare provider to assess joint function and overall recovery are essential. They can provide ongoing guidance and adjust your rehabilitation plan as needed.

In summary, by modifying your activities, engaging in appropriate rehabilitation exercises, maintaining a nutritious diet, and monitoring your symptoms, you can significantly reduce the risk of developing arthritis after your radial head injury. Remember that recovery is a gradual process, and patience is key. Focus on what you can control, and continue to seek support from your healthcare team as you navigate your recovery journey.

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