Impact of Delayed Surgery on Distal Radius Fractures

Radial head fracture

I fell and broke my wrist on December 20th last year while trying to catch myself.
I've been struggling with the decision of whether to have surgery.
After reviewing the reports and consulting with my doctor this week, I've decided to proceed with the surgery.
Will the delay in having the surgery affect the outcome?

Jingjing, 30~39 year old female. Ask Date: 2015/01/14

Dr. Chen Yongxue reply Orthopedics

The letter does not specify which bone is fractured, nor does it clarify the severity of the fracture.
However, if an orthopedic surgeon recommends surgical treatment, it is likely that surgery would be more beneficial for the healing process.
Fracture healing has a time-dependent aspect; theoretically, the sooner the surgery is performed, the stronger the healing capacity.
However, since time has already passed, further discussion may be unproductive.
It is advisable to visit an orthopedic outpatient clinic for further recommendations.

Reply Date: 2015/01/14

More Info

The impact of delayed surgery on distal radius fractures can be significant and multifaceted. When a fracture occurs, especially in the distal radius, timely intervention is crucial for optimal recovery. Delaying surgery can lead to several complications, including malunion or nonunion of the fracture, prolonged pain, decreased range of motion, and potential long-term functional impairment.

In your case, since the fracture occurred on December 20 and you are only now considering surgery, there are several factors to consider. First, the type of fracture you have (e.g., whether it is a simple or complex fracture) plays a critical role in determining the outcome of delayed surgery. Complex fractures, particularly those involving displacement or fragmentation, may not heal properly if surgery is postponed. This can lead to malunion, where the bone heals in an incorrect position, or nonunion, where the bone fails to heal altogether.

Another important aspect is the risk of stiffness and loss of function in the wrist and hand. The longer the fracture remains untreated, the more likely you are to experience stiffness in the surrounding joints and soft tissues. This can result in decreased range of motion and functional limitations, making rehabilitation more challenging after surgery.

In addition to these physical concerns, there is also a psychological component to consider. Prolonged pain and limited mobility can lead to frustration and anxiety, which may affect your overall recovery process. Engaging in physical therapy post-surgery will be essential to regain strength and mobility, but the longer the delay before surgery, the more intensive and prolonged the rehabilitation may need to be.

Moreover, the risk of complications such as infection increases with time, particularly if there is any open fracture or if the skin integrity is compromised. If the fracture is stable and there are no signs of complications, surgery may still be beneficial, but the surgeon will need to assess the fracture's healing status and the surrounding soft tissues.

In conclusion, while surgery can still be performed after a delay, it is essential to understand that the outcomes may not be as favorable as if the surgery had been performed sooner. It is crucial to discuss your specific case with your orthopedic surgeon, who can provide tailored advice based on the nature of your fracture, your overall health, and the potential risks and benefits of proceeding with surgery at this stage. They may also recommend a comprehensive rehabilitation plan to help you regain function and strength in your wrist and hand post-surgery.

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