Wrist Fractures: Managing Pain and Recovery After Injury

Wrist fracture

Hello Dr.
Chen,
Five weeks ago, I fractured the bones in my right wrist while skiing.
Since then, I have been wearing a new type of hard splint that is similar to a cast and cannot be removed freely.
During this time, my arm has been kept in a flexed position to allow the wrist bones to heal, so I haven't been able to let it hang down during the day.
However, whenever I stretch my arm out at night while sleeping or practice extending my arm upward during the day, I experience significant pain in my elbow joint.
Is this phenomenon normal due to not being able to lower my arm for five consecutive weeks? I still have over a week left before I can remove this splint, so are there any methods to improve this situation? Additionally, I currently feel as though there is a layer between my fingers when I touch them.
Is it possible that the nerve pathways may not recover? Thank you for your patience and answers, doctor.

Xiao Yong, 20~29 year old female. Ask Date: 2015/09/21

Dr. Chen Yongxue reply Orthopedics

Hello, the letter did not specify which bone in the wrist (I suspect it might be the scaphoid bone).
If it is the scaphoid, it can be more complicated.
The casting must be applied carefully, as the application of the cast can lead to joint stiffness, which is normal.
After the cast is removed, rehabilitation therapy will help improve the condition gradually.
Don't worry too much.
If you have any other questions, feel free to visit the orthopedic clinic for further consultation.
Thank you!

Reply Date: 2015/09/21

More Info

Hello! It sounds like you are dealing with a challenging recovery process after your wrist fracture from skiing. Let's break down your concerns regarding pain management, recovery, and the sensations you are experiencing.

Firstly, it is not uncommon to experience discomfort and pain in the elbow joint after a wrist fracture, especially when the arm has been immobilized for an extended period. The reason for this discomfort can be attributed to several factors:
1. Joint Stiffness: When a limb is immobilized, the joints can become stiff due to lack of movement. This stiffness can lead to discomfort when you attempt to extend or move the arm, as the surrounding muscles and tendons may not be accustomed to the movement after being held in a fixed position for so long.

2. Muscle Atrophy: Prolonged immobilization can also lead to muscle atrophy (weakening of the muscles) in the arm and shoulder. This can contribute to pain and discomfort when you try to use the arm, as the muscles may not be strong enough to support the movements you are attempting.

3. Nerve Sensitivity: The sensation of your fingers feeling like they are "behind a layer" could be related to nerve sensitivity or compression. When the wrist is immobilized, the nerves that run through the wrist can become irritated or compressed, leading to altered sensations. This is often temporary and should improve as you regain movement and circulation in the area.

To manage your current situation and improve your recovery, here are some recommendations:
1. Gentle Range of Motion Exercises: As soon as you are cleared by your doctor, start performing gentle range of motion exercises for your elbow and wrist. This can help reduce stiffness and improve circulation. Make sure to do this under the guidance of a physical therapist if possible.

2. Elevation and Ice: To manage pain and swelling, especially if you are experiencing discomfort in the elbow, try to keep your arm elevated and apply ice packs to the area for 15-20 minutes several times a day. This can help reduce inflammation and provide some pain relief.

3. Gradual Strengthening: Once your doctor gives you the green light to remove the immobilization device, gradually start strengthening exercises for your wrist and elbow. This can include squeezing a soft ball, wrist curls, and other resistance exercises to build strength.

4. Physical Therapy: Consider seeking physical therapy after your immobilization device is removed. A physical therapist can provide tailored exercises and treatments to help you regain strength, flexibility, and function in your wrist and elbow.

5. Monitor Sensation Changes: Keep track of any changes in sensation in your fingers. If you notice persistent numbness, tingling, or weakness, it is important to follow up with your healthcare provider. They may want to evaluate for potential nerve issues or other complications.

6. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as acetaminophen or ibuprofen can be helpful. However, consult your doctor before taking any medication to ensure it is appropriate for your situation.

In summary, while it is normal to experience some discomfort and altered sensations during the recovery process, it is crucial to follow your doctor's advice and engage in rehabilitation activities as soon as you are able. With time, patience, and appropriate care, you should see improvement in both your pain and the sensations in your fingers. Always communicate with your healthcare provider about any concerns you have during your recovery. Best wishes for a smooth healing process!

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