My wrist fracture

Bones, joints and muscles
1

Hi, I'm a new user. This is not a cry for help, but I mainly want to share my story in case anybody is interested.

I fell while ice skating about 3 weeks ago, and broke my right wrist. It turned out to be a quite severe distal radius fracture. I got more details about it little by little, and now I know that it's an intra-articular comminuted fracture (still don't know how many pieces), and the ulna was cracked too, but not serious.

They first did a closed reduction (quite painful) and put it in a cast, but it wasn't sufficient for stabilizing the fracture. The doctor recommended surgery for internal fixation, and I accepted. I had the surgery 4 days after the accident, under general anesthesia, and it went fairly well. They put in a T-shaped titanium locking plate with 7 screws (5 on the "top" side). I had moderate to severe pain right after waking up, but they gave me some pain killers and it got better, and I managed it with only paracetamol afterwards. No cast after the surgery, only a dressing.

I started physiotherapy exercises the next day (fingers, elbow and shoulder mobility), very hard in the beginning, but gradually getting better. Still had mild to moderate pain, especially when getting up, but manageable with paracetamol and slowly improving. About 10 days later I consulted a physiotherapist and he immediately got me started doing wrist exercises, with great frequency, and advised me to use ice more often too as I still had significant inflammation. Exercises are hard and unpleasant, but I could notice my wrist improving day to day.

Now I am able to move all my fingers (and thumb) quite easily, and I can type; my grip strength is also better. But my wrist is still very stiff, can only bend it about 30 degrees (flexion and extension), have mild pain from time to time, and still can't do many things with my right hand.

I have some followups next week, I hope things will go well. The physiotherapist said I might end up with some permanent limitation in the range of motion of the wrist, but nobody knows that yet. I wonder if my progress so far is good, but I'm not very concerned. I can see that other people went through a lot worse, and I'm thankful that I'm doing as well as I am.

I just have one question: after getting the stitches removed and dressing changed with a smaller one, I could see an unexpected small wound near the incision (about 2.5 cm/1 inch away, on the side of my wrist) that I was not aware of before. It looks like I was stabbed with a small screwdriver. It must have happened during the surgery, is it part of a normal procedure? Anyway, I expect it will heal without any issues.

Finally, feel free to ask me questions if you'd like to know more about my experience.

2

I wish you well in your recovery- to be fair it sounds like it is going well. Hopefully the pain will ease. I think the experience of most is that physio in particular hurts but long term the pain is worth it for the benefit you get.

My story was similar in some respects until the point of surgery where I had k wires not internal plates. I also went into a cast for a further six weeks.

Mi still have scaring from the op and it will likely remain visible for the remainder of my days. Oddly i also have a "puncture" scar like you described. I am not sure if its the way the incision is made.

I am not overly concerned about it - I was just greatful to get most of the movement back and get back to normality.

Good luck and keep up the physio!

3

Thank you very much. As I said, I just have occasional mild pain now (besides the physio).

Yes, I'll have a significant scar, that's the way it is. I'll figure out what (if anything) to do about it later. Btw, they said I can keep the plate forever if it doesn't cause me problems (I'm not looking forward to another operation).

And "puncture" is a good description for the other small wound. Don't know if it will leave a scar, it's small anyway.

4

My physio is heavily into acupuncture and also uses botox to assist with well being (as opposed to its other use). He did offer to use some of these thearpies to help my scar tissue reduce. I wasn't that fussed and was concentrated on getting movement back for sport

Worth considering though as it is an option to help reduce scar tissue if you are concerned by it

5

Hi there, I broke my wrist at the end of December and also started with a closed reduction and cast but after three weeks was advised that it was slipping out of position so I had a plate and screws put in under regional anaesthetic. Like you I had severe pain initially but this soon settled down. I started physio after another two weeks once the bandages and stitches came out. After about a month of this I have good mobility through my fingers, can write and type and use my hand for most light tasks but still have quite limited flexion and rotation. Icing has helped with swelling and pain. All the advice I have had is that full recovery can take up to a year so I am trying to focus on the positive and appreciate what I can do. As you are only three weeks post op you are still in the very early stages...I have definitely made progress in six weeks and am hopeful that it will continue if I keep exercising and using my hand as much as possible.

6

Aww that must have been disappointing.. having to start over after 3 weeks. And were you conscious during the operation? They gave me the option to have a regional anesthetic, using a nerve block, but I preferred to be knocked out while they cut and drill and do the thing.

Glad to hear you're getting better, and yes, recovery can take a long time (I heard that it may continue to improve slowly for up to 2 years). I really hope we can achieve full recovery.

7

Your extremly lucky my daughter fractured her right distal radius had kwiring intense physio exercises to this day on the hour every hour and still only has 45% movement shes had a plastic splint moulded n put on since january , it does help but she still can't bend it etc she had her accident on 23/2/16 so a year on n she needs further surgery , cant write do buttons do zips tie laces wash her hair put her hair in a bobble, she can't do anything a normal 12yr old girl can do

8

Oh, I'm sorry to hear that. Is she unable to bend her fingers easily, or just the wrist? And did the doctors find the reason? Hope they can fix it soon..

9

She can bend fingers , but muscle in hand all wasted away, the orginal surgeon has set the bone at a slight angle so a bone is clicking in n out of place at the join were hand and wrist start u can here it clicking n can feel it doing it, there not sure what they can do yet its gone in front of a panel to decide (new hospital & new surgeon after 6mnths of me begging ) the new surgeon said its very risky due to nerves tendons n something else , so its wait and struggle on again for now

10

Hi, sorry to hear you broke your wrist. Wrist fractures sound like 'oh just a broken wrist' but I would rather have broken a leg. My story is very complictaed ending with a wrist fusion and 14 months on still not got much function, (I was in a cast for the best part of a year) but I'm replying regarding the small incision you have away from the main surgery I had that too, when I asked the consultant he said 'no you wouldn't have had an incision there'! There was alot going on at the time because of others problems he was trying to sort out so I didn't persue it but it's definitely there. When I see him next I may ask again as I'm just curious I think it must be to put a securing intrument in or something.Did you also have a carpel tunnel release at the same time? thought it may be related to that.....I'll let you know. Good luck 

11

Ooh nasty, I have this too but my wrist is fused now following 5 surgeries. At 12 avoid this as it is very disabling for her whole life. Look at and research a Schekler implant as an option, obviously it may not help in her case as I don't know the specifics but it is something I am looking at to regain some more function. My wrist will never bend I know that becuase it is fused. I contatced Dr Schekler and he replied saying this would help me with the rotational movements which would be something. The implant is used in uk by some surgeons.

I feel for your daughter as I understand the frustrations of not being able to do buttons, hair ties etc I can't reach things of high shelves, take change at a til or pick a piece of paper off the floor. Having said all that she is young enough to adapt but explore all the options first. Good luck and I would be interested to hear the outcome of her panel x

12

Hi, I don't know about the leg, being able to walk is quite important too. But your case sounds really terrible; from what I've read, wrist fusion should only be a last resort, e.g. when the articulation is severely damaged. Fortunately, my recovery seems to be going ok so far.

I totally forgot to ask the doctor about the small incision last time. I wonder if they used an arthroscope or something. I'll make sure to ask at the next followup. I didn't have anything done about the carpal tunnel (or at least nobody mentioned it).

Wish you all the best, I hope the doctors can find a way to restore your wrist function.

13

I had another followup today, almost 7 weeks since surgery. Bone alignment is good, but it's still taking time to join and heal.

Finally got an answer about the puncture wound (which has mostly healed in the meantime) - the doctor said it was most likely from a temporary K-wire that was used during surgery. The idea is that they first inserted a K-wire to secure the bones, then attached the plate, then removed the K-wire.

I have no pain most of the time now, and can do more things with my right hand. Flexion and extension are up to about 60 degrees now, pronation and supination almost full, and grip strength around 50% compared to my left hand. Still need to keep putting ice on the wrist and doing physiotherapy exercises (which are not that unpleasant anymore, just time consuming).

I've been using some "scar reducer" polyurethane patches for my scar after getting rid of the dressing pads; I kinda like how they feel and the fact that they are transparent and also provide some protection. Not sure how much they will actually reduce the scar, but probably can't hurt.