Disagreement over ulnar styloid fracture

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i fell just over two weeks ago onto my outstretched hands. In A&E they thought it was just sprains and I was sent home with a splint on left hand.  Hospital rang two hours later to say that X-Ray had been reviewed by radiologist and did show a small fracture to ulnar styloid. I was put in resting plaster but yesterday Orthopaedic Consultant looked at original X-Ray and said it was not broken so I am now back in splint!  It is still very painful in the same area, particularly if I try to flex the wrist (with splint off). Is it unusual to get this sort of disagreement?  I'm not convinced it is just a sprain as I get intense pain in the ulnar area if I make the wrong movement. It seems OK in splint though. Any advice or experiences would be welcome. Thanks.

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  • Posted

    Hi Celiamary; Yes, I'm sorry to say that I have witnessed this many times  (the conflicting evidence/diagnosis of specialists); however, I for myself, would agree with the Radioligist, who is a trained doctor, who has specialized in reading x-rays etc.  Also the fact that it "hurts" to move wrist when not stabilized in splint.  Are you seeing a Private Orthopod or going through the public system?  Some of the "doctors in the public system" are not fully  trained if they are doing an Orthopaedic clinic.....my suggestion is to keep wrist in backslab/splint or another 4 - 6 weeks and do some small movements/exercises that a Physio may suggest for you, and give your fracture time to set properly.  If by this time you are still having abnormal pain (you may always have some pain on a fractured site), then perhaps your GP could ask for another x-ray to see what is happening???    If you are attending a private Orthopod, then perhaps getting a second opinion may also be necessary?  Hoping this helps??

    ?Good luck..............Bron

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    • Posted

      Thanks for responding. It was an Orthopaedic Consultant (so the most qualified in the UK) I saw yesterday (at my local hospital) but you have made me feel more confident that my suspicions might be true - he was very dismissive of the radiologist's opinion and called it 'defensive medicine'! I have a splint with a metal strip on and have found some exercises online which I am attempting cautiously twice a day. Some of them I can't do because it hurts - I am being very careful. . What I also have is an SOS to go back to the Fracture Clinic if it doesn't settle down so I will use that if necessary although I may end up with the same doctor of course!   My instinct was that a trained Radiologist would be unlikely to 'imagine' a break, albeit a small one, so thank you for your advice. Celia

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    • Posted

      I would ask for a copy of the X-rays where the radiologist noted the fracture and the report that goes with them and take them with you if you go for another opinion...also lets not forget that your fracture needs time to heal so don't push it to far with the exercises for the first 4 weeks or so listen to your pain.

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    • Posted

      bronwyn, you are so right on this, I wish I had just not worried about going into work and aggravating them about when was I gonna hear something about the hand specialist and just kept the half cast on my hand and maybe I wouldn't be dealing with all this mess I'm dealing with. Everybody wants to be right about their diagnosis, but I feel like the Radiologist is a doctor like you said and that's all he does all day long, so he should know what their talking about.

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  • Posted

    You are fortunate. Stay in the splint.

    My doc put me in a fiberglass cast that sent me to the ER with high blood pressure. I then put myself in a splint. Am going to see a professional about my future  - ulna was dislocated but no one noticed it.

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  • Posted

    Celia, I am going through the same kind of thing you are. I fell at work on June 30, I filled out an incident report just in case but my ankle twisted and I knew pretty much it would hurt but I went to HR the next morning and picked a place to go for x-rays and when I got up there and the doctor checked me out he ask if I thought I broke it and I said no cause I really didn't think it was broken I thought maybe badly bruised but when all was done they came in and ask me when was the last time I had anything to eat and drink and I told them 5:30am on the food and 9:00am on the drink so it was almost 12:00 noon and they said that I had a Intra-Articular Distal Radius Fracture and was trying to find an Ortho doctor still in but since it was number one the weekend of the 4th of July and Friday they couldn't find one still in so they put me in a half cast on the thumb side and referred me to be checked out by a hand specialist so I went back to work and they had to put a call into worker comp and after that they finally got me in with an Ortho that specialized in the Hand I went to him on the 12th of July and He did the same thing yours did. He said that the fall had caused me to have an Arthritic Episode & yes I do have Arthritis and no it didn't feel like an episode with Arthritis so he told me not to do any pinching/gripping with my thumb so I didn't, I just used my other fingers to do my job I went back to him because the pain was so bad and he said same thing and gave me a Cortisone Injection which I've had before so I knew if it was in deed Arthritis then the injection should make it better within a couple of days after. I knew when he gave it though it wasn't done the way the other doctor that I see for the Arthritis did it he would pull the joint apart a little very gently to make sure it was in the joint good and then in a few hours it would feel better then couple days on top of the world. This doctor didn't pull the joint apart to allow it to get into the joint good and when he stuck the needle in I could swear he hit something. Needless to say that things have went down hill ever since. I have went from having pain just in my thumb and the chunky part at the base/palm of my hand to pain shooting across my wrist and up the side of my arm on the pinky side up towards my elbow and the palm of my hand fills like it's been slammed over and over in a door I just feel like crap all the time and I can't stand to go without anything on my hand because he had switched me to a CMC brace which is a little more comfortable and doesn't have metal in it but I had kept on working just minimizing using my thumb. After I started feeling all the pain in wrist and going up my arm and down into my palm of my hand and in last three fingers bird through pinky I had called for something for pain and they scheduled me to come back in for appt when I went back on Aug 10 the doctor did another exam on my Hand/Wrist and had me squalling for the second time he then decided that I was to do no work with my left arm at work until further notice. He had me go for an MRI and with results he says Arthritis looks the same as the year before when it was diagnosed and I'm thinking, that's because it's not Arthritis, now he has decided he's sending me for an ERG with a Neurologist to do a Nerve Conduction test because he thinks now that it's possible that I have Carpel Tunnel and he's took 4 sets of x-rays and an MRI and now this upcoming tomorrow. He hasn't said anything about a Bone Scan which is what I think he should do. To shorten this up a little I have a couple of doctor friends, one who is a Chiropractor and I have went o him on ocassion and known him for over 27 yrs and I know he knows what he's talking about and another doctor who is an Ortho Doctor and they both tell me I had a hairline fracture a small one but it was there, plus 3 doctors at the first place I went to so I don't know what his problem is with seeing it, but I'm paying the price. I ask to switch doctors not far into this and workers comp case worker said I couldn't switch yet and to wait on results of MRI which I knew I wanted the second opinion before I went for the MRI because I don't know about this doctor , I read a review and he had one and it wasn't a good one. Then I find out just the other day that he's the same surgeon that worked on my sister-in-law and she said her knuckle wasn't the same and still causes her pain but before I knew this I had already made up my mind that he wasn't gonna do any cutting on me. I do feel for you hun and we're in the same boat apparently. I wish you all the best of luck and keep us updated on your situation and May God bless you.

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