Rehabilitation After Distal Radius and Elbow Fractures: What You Need to Know

Comminuted fracture of the radius and elbow?

Hello Doctor, I was in a car accident in mid-October and sustained a comminuted fracture of the distal radius in my right wrist, as well as a comminuted fracture of the olecranon in my right elbow.
After surgery, I have two steel pins left in my elbow, but the external fixator and cast on my wrist were removed.
On the 30th, after the cast was taken off, the doctor gave me a soft sponge block to practice grip strength.
However, my elbow's range of motion has decreased, and I cannot fully extend it, and my wrist also has limited mobility.
I would like to ask if I can start rehabilitation now.
It has only been a month and a half, and I am concerned that the bones may not have healed yet, so I am currently only doing grip strength exercises.
Thank you, Doctor.

Xiao Xiao Bing, 30~39 year old female. Ask Date: 2015/12/01

Dr. Shi Guozheng reply Orthopedics

Rehabilitation can be performed because prolonged immobilization can lead to joint stiffness.
Currently, grip strength training is appropriate, and the wrist joint must also begin to mobilize.
If the fixation of the radius is secure, then movement is generally permissible.

Reply Date: 2015/12/01

More Info

Rehabilitation after distal radius and elbow fractures is a critical process that can significantly influence your recovery and overall functionality. Given your situation, where you have sustained a comminuted fracture of the distal radius and an olecranon fracture, it is essential to approach rehabilitation cautiously and systematically.

Understanding Your Injuries
1. Distal Radius Fracture: This type of fracture occurs near the wrist and can significantly affect wrist mobility and strength. Comminuted fractures, where the bone is shattered into several pieces, often require surgical intervention and can lead to complications if not rehabilitated properly.

2. Olecranon Fracture: The olecranon is the bony prominence of the elbow. Fractures in this area can impair elbow extension and flexion, leading to stiffness and reduced range of motion if not addressed through rehabilitation.

Importance of Rehabilitation
Rehabilitation is crucial for restoring function, strength, and range of motion in the affected areas. It helps in:
- Reducing Stiffness: After immobilization, joints can become stiff. Rehabilitation exercises help to regain mobility.

- Restoring Strength: Gradual strengthening exercises are necessary to rebuild muscle strength around the wrist and elbow.

- Improving Functionality: The ultimate goal is to return to daily activities without pain or limitation.

When to Start Rehabilitation
You mentioned that it has been a month and a half since your surgery. Typically, rehabilitation can begin once the surgeon confirms that the fractures are healing adequately. Since you have had your cast removed and are already engaging in some exercises, it indicates that you may be ready to start a structured rehabilitation program. However, it is crucial to follow your doctor's advice regarding the timing and intensity of rehabilitation.

Recommended Rehabilitation Steps
1. Consult Your Doctor or Physical Therapist: Before starting any rehabilitation exercises, consult with your healthcare provider or a physical therapist. They can assess your healing progress and tailor a rehabilitation program specific to your needs.

2. Gentle Range of Motion Exercises: Start with gentle range of motion exercises for both the wrist and elbow. These can include:
- Wrist flexion and extension.

- Elbow flexion and extension.

- Forearm pronation and supination.

3. Strengthening Exercises: Once you have regained some range of motion, you can begin strengthening exercises. These may include:
- Squeezing a soft ball or putty to improve grip strength.

- Resistance band exercises for wrist and elbow flexion/extension.

4. Functional Activities: Gradually incorporate functional activities that mimic daily tasks, such as lifting light objects or performing hand movements required for daily living.

5. Pain Management: If you experience pain during rehabilitation, it is essential to communicate this with your therapist or doctor. They may adjust your rehabilitation plan accordingly.

6. Monitor Healing: Regular follow-ups with your doctor are necessary to monitor the healing of your bones. X-rays may be taken to ensure that the fractures are healing properly.

Precautions
- Avoid Overexertion: It is crucial to avoid pushing through pain. If an exercise causes significant discomfort, stop and consult your healthcare provider.

- Listen to Your Body: Pay attention to how your body responds to rehabilitation exercises. Gradual progression is key to avoiding setbacks.

Conclusion
Rehabilitation after distal radius and elbow fractures is a gradual process that requires patience and diligence. Starting with gentle exercises and progressively increasing intensity under professional guidance will help you regain function and strength. Always prioritize communication with your healthcare team to ensure a safe and effective recovery. With time and effort, you should be able to return to your normal activities.

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