Joint Stiffness and Treatment Options for Delayed Healing

Joint stiffness

Dr.
Chen, I have no bad habits and my physical condition is okay.
I received treatment on the day of my injury.
May I ask about my closed distal radius fracture, which has been internally fixed and has shown delayed healing for over four months? Besides checking the strength of the plates and screws, or possibly removing the small head and installing artificial bone, what other treatments can be done to promote healing? How is the healing capacity assessed? Regarding the stiffness of the elbow joint, how is the open release of the tendons performed? Thank you.

123, 30~39 year old female. Ask Date: 2015/09/27

Dr. Chen Yongxue reply Orthopedics

Hello, regarding your inquiry, it likely refers to a fracture of the radial head or neck of the radius.
If that is the case, it would be better to perform a reduction, as fractures in this area tend to heal more slowly and often lead to stiffness in the elbow joint.
I recommend visiting an orthopedic clinic in person to determine the best course of action based on the X-ray results.
Additionally, there are two types of elbow release procedures: closed and open, which should be decided based on the condition.
Thank you.

Reply Date: 2015/09/27

More Info

Understanding joint stiffness and treatment options for delayed healing is crucial, especially after an injury such as a closed radial fracture. It seems you have been dealing with this issue for over four months, and it’s understandable to be concerned about the healing process and the potential for joint stiffness.

Joint Stiffness and Delayed Healing
Joint stiffness can occur for various reasons, particularly after an injury. In your case, the closed radial fracture may have led to immobilization, which is necessary for healing but can also result in stiffness due to the lack of movement. When a joint is not moved for an extended period, the surrounding muscles and connective tissues can become tight, leading to decreased range of motion and stiffness.

Delayed healing, or nonunion, can occur for several reasons, including inadequate blood supply, infection, or improper alignment of the fracture. In your situation, it’s essential to evaluate the strength of the fixation (the plates and screws) and ensure that the fracture is stable. If the fixation is inadequate, it may need to be reinforced or revised.

Treatment Options
1. Physical Therapy: One of the first lines of treatment for joint stiffness is physical therapy. A physical therapist can guide you through exercises designed to improve range of motion, strengthen the surrounding muscles, and reduce stiffness. This can be particularly beneficial if you have not been able to move the joint adequately since the injury.

2. Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation, which may contribute to stiffness. However, they should be used under the guidance of a healthcare provider.

3. Surgical Options: If conservative measures fail, surgical intervention may be necessary. Here are some surgical options that could be considered:
- Revision Surgery: If the current fixation is inadequate, a surgeon may recommend revising the fixation with stronger plates or screws.

- Bone Grafting: If there is a concern about the healing of the fracture, a bone graft may be used to promote healing. This involves taking bone from another part of your body or using synthetic bone material to help stimulate healing.

- Open Release Surgery: If joint stiffness is significant, an open release procedure may be performed. This involves surgically accessing the joint to release tight structures (such as ligaments or tendons) that are limiting movement. The surgeon will carefully evaluate the joint and surrounding tissues to determine the best approach.

4. Joint Mobilization Techniques: In some cases, manual therapy techniques performed by a skilled therapist can help improve joint mobility and reduce stiffness.

5. Assistive Devices: Depending on the severity of the stiffness, using assistive devices such as braces or splints may help support the joint while allowing for some movement.

Prognosis and Recovery
The prognosis for joint stiffness and delayed healing can vary based on several factors, including the extent of the injury, the effectiveness of the treatment, and your overall health. With appropriate treatment, many individuals can regain significant function and reduce stiffness over time. However, it’s essential to follow up with your healthcare provider regularly to monitor your progress and make adjustments to your treatment plan as needed.

In conclusion, addressing joint stiffness and delayed healing requires a comprehensive approach that includes physical therapy, medication, and possibly surgical intervention. It’s crucial to communicate openly with your healthcare provider about your symptoms and concerns to develop an effective treatment plan tailored to your needs.

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