Effective Rehabilitation Strategies for Elbow and Forearm Recovery

Elbow rehabilitation

Doctor, I am the one who asked about the rehabilitation for the radial head fracture that was treated with plate fixation last time.
How should I treat the hand stiffness? The doctor mentioned that the last two fingers are numb due to the position of the splint.
It has been numb for a month, and it seems to be getting more numb.
How long will this numbness last?

Fujian, 40~49 year old female. Ask Date: 2015/12/29

Dr. Hong Ximing reply Orthopedics

Elbow contracture still requires diligent rehabilitation therapy.
For finger numbness, it is important to determine whether it is caused by ulnar nerve entrapment.
An ulnar nerve conduction study can be performed first, followed by a discussion with the attending physician.

Reply Date: 2015/12/29

More Info

Effective rehabilitation strategies for elbow and forearm recovery, especially after a radial head fracture that has been treated with plate fixation, are crucial for restoring function and alleviating symptoms such as pain and numbness. Given your situation, where you are experiencing stiffness in your hand and numbness in your last two fingers, it is essential to approach your rehabilitation with a comprehensive plan that addresses both the physical and neurological aspects of your recovery.

Rehabilitation Strategies
1. Early Mobilization: After surgery, it is vital to begin gentle range-of-motion exercises as soon as it is safe to do so. This helps prevent stiffness and promotes circulation. Your physical therapist can guide you through specific exercises that target the elbow and forearm, focusing on flexion, extension, pronation, and supination.

2. Strengthening Exercises: Once you have regained some range of motion, your rehabilitation program should include strengthening exercises. These exercises can help rebuild muscle strength around the elbow and forearm, which is essential for functional recovery. Resistance bands or light weights can be introduced gradually.

3. Neuromuscular Re-education: Given your symptoms of numbness, it is important to incorporate neuromuscular re-education techniques. This may involve sensory re-training exercises to help your brain reconnect with the affected areas of your hand. Your therapist may use techniques such as desensitization or graded exposure to different textures and sensations.

4. Therapeutic Modalities: Various modalities, such as ultrasound therapy, electrical stimulation, or heat/cold therapy, can be beneficial in managing pain and promoting healing. These treatments can help reduce inflammation and improve blood flow to the affected area.

5. Splinting and Positioning: If you are experiencing significant stiffness or deformity, your therapist may recommend the use of a splint to maintain proper alignment and prevent further complications. Proper positioning during rest can also aid in recovery.

6. Education and Activity Modification: Educating yourself about your condition and learning how to modify daily activities can significantly impact your recovery. Ergonomic adjustments to your workspace or daily tasks can help reduce strain on your elbow and forearm.

Addressing Numbness
The numbness in your last two fingers could be related to compression of the ulnar nerve, which can occur due to swelling or improper positioning after surgery. It is essential to monitor this symptom closely. Here are some strategies to address it:
- Nerve Gliding Exercises: These exercises can help mobilize the ulnar nerve and reduce symptoms of numbness. Your therapist can provide you with specific exercises to perform regularly.

- Posture and Ergonomics: Ensure that your posture is correct during activities, as poor positioning can exacerbate nerve compression. Avoid resting your elbow on hard surfaces for prolonged periods.

- Regular Follow-ups: Keep in close contact with your healthcare provider. If numbness persists or worsens, further evaluation may be necessary to rule out any complications, such as nerve entrapment or other underlying issues.

Conclusion
In summary, effective rehabilitation after a radial head fracture involves a combination of early mobilization, strengthening exercises, neuromuscular re-education, and therapeutic modalities. Addressing the numbness in your fingers is equally important, and working closely with your rehabilitation team will ensure that you receive a tailored approach to your recovery. Remember, recovery can take time, and persistence is key. Regular follow-ups with your healthcare provider will help monitor your progress and make necessary adjustments to your rehabilitation plan.

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