Shattered Distal Radius

Hi all,

Wrist still painful and rigid - going for the paraffin wax hand bath this week and physio will try and manipulate wrist - I know I need to be patient but no nearer being able to rotate hand.  Doing excercises while in a hot shower seems less painful.

 

Hi everyone , just checking in on the 4 month anniversary of breaking my wrist.

I am still unhappy with the slow progress but tryng to remain positive. My wrist and fingers are still stiff and painful, despite tons of physio , hot and cold hand baths, etc etc.  I am having acupuncture this week which will be interesting. I still can't work out if I am being negative and impatient, or if this is normal for a 59 year old. Apparently the older you are, the longer things take to heal and settle down! I think my main problem is that it is my dominant hand and the fact that I still can't chop vegetables, write, put on the hand brake, turn my wrist over to receive change from a shop assistant, etc etc etc etc , is all pretty depressing.And I have had my plaster off for 10 weeks now! Am I expecting too much, too soon?

By the way Neil, I have ordered a paraffin bath!

Hi Jeannette and everybody!

I have been reading this forum for a while, holding my "shattered wrist" and hoping to be able to use it again. It really has helped a lot! I haven't found anything comparable in italian (my mother tongue) and when I found you all, dealing with the same problem I have been facing in the last month, I have seen a light.

My story: I fell on ice on december 30th, far from my home town. I went to ER where I have the diagnosis (left distal radius comminuted fracture). I had to sign to leave because they wanted me to have surgery there. I went back home (in Rome) with a cast. I had surgery on January 8th (plate and pins) and went home with a splint that I kept until january 28th when I had splint and stitches removed.

I started physio on 31st and am now on my 4th day with specialist + physio on my own everyday at home. My wrist is still rigid as a piece of wood but I can see small improvements every day.

I suggest never desist from exercising elbow  and shoulder, also with splinter and cast. I used to help me with the right hand and move both elbow and shoulder up and down trying not to keep them too stiff. It is also important to move your fingers, doing a fist and extending them. Once you will have your splinter removed it will be much easier. I have always been able to digit on my notebook. Now, after 36 days from the event, I have almost a complete pronation and am working on supination (70% now, quite a good result I would think).

My idea when I found out what I had suffered was: I will have cast for a month or little more, than remove it and after one week/10days I will be back in action. Now I know it will not be like that and that I will have to be patient and exercise a lot in order to learn again to move my wrist in the proper way.

But the opinion of each one of you has helped a lot. 

I will try and post my improvements in the next days. Thank you all and sorry for my english!

First of all, thanks Jeanette and everyone for keeping this post going – I can't tell you how helpful it's been in reassuring me that my experience is not abnormal. Now I’m adding a much-too-long post; sorry, but hope some of it's helpful. 

My break occurred10 weeks ago, but what made it difficult was that I’m living in France where things get lost in translation. The upside of being here was that operative care was excellent – I turned up at hospital and after x-Rays and assessment was admitted within a few hours. I had my operation the next day and was kept in for observation a second night. The downside was that I was given virtually no advice on post-op management, so I suffered shocking pain till I worked out how to take my medication. And almost everything I learnt about the injury came from the internet. I didn't see any medical staff until I went back after 6 weeks to have the cast and pins removed.

My operation used percutaneous pinning, which seems to be the most popular technique in France and so far at least, seems to have worked well for me. There were 2 surgeons, but a different doctor removed the cast and pins, and applied 4 sutures where the pins had been (one later fell out so I’m trying to repair a hole). He also told me I should remove the sutures myself. Oh yeah? I decided not to do that and instead had them removed by a Spanish nurse when I was on a short trip to Madrid – she was great. I found my physical therapist myself too, here in Paris, and he's also good.

The main thing I learnt was not to be reluctant  to take pain medication. This is one time when it really is justified. The medication I was prescribed was a combination of codeine and paracetamol but it's slow-acting so if you wait till the pain sets you will go through agony for another hour or more before it takes effect. I learned the hard way to take medication before the pain comes back, even if it meant exceeding the maximum daily dose – that’s only necessary for a few days or up to a week, and then it's possible to drop back. My prescription said no more than 6 tablets a day, but for the first week the pain came back after 3 hours and waiting another hour to take something, then another 45 minutes for it to take effect was intolerable, so I took 8 a day until the worst had past. This approach is also recommended in contemporary surgical practice, but it's not what a lot of surgeons do.

The second thing I realized is that pain levels jump around. Week 1 was shocking, perhaps worse because I had no idea what to expect, week 2 it seemed to be improving (so I made the mistake of drastically cutting back the meds, ow!), week 3 was awful, and it went in fits and starts, with slow improvements, then back to bad pain, etc. It's still like that, but at much lower levels of intensity.

One more thing about pain. As far as I could tell, I went through 3 types of pain and part of the agony is the combination of the three. The first seems to be both post-op pain and the bone itself, as it recovers from manipulation and starts to knit. It's intense and very focused and is most severe immediately post- op but the worst of it diminishes quite rapidly. The second is nerve pain, or neuropathy, nasty brutish stabbing pain that comes and goes. Associated with this is intense sensitivity if the cast is touched. That's caused mostly by the cast and it went completely when my cast was moved. The third, which continues for me, is soft tissue damage (ligaments and tendons) and that's slowly improving as they repair and I use exercises to lengthen and strengthen them. Then of course there’s pain caused by stiffness: the more we use our hands and wrists the more we’ll get that under control.

I also realized, eventually, that it [u]is[/u] possible to have a decent night's sleep – with help. After 6 weeks of sleeping no more than 3 hours a night, I mentioned the problem to the doctor, who prescribed sleeping tablets. They’ve made a huge difference to my well being.  Shouldn't it be a standard offering after an op like this? .

I’ve learnt lots of things from my therapist – any questions, just fire away, and if I don't know the answers I’ll ask him. But he did say that therapy should ideally start while the arm is in a cast, otherwise it sets back rehab. I didn't do that but the one thing I did do was to move my fingers about and that's essential because it helps bring blood to the hand and thus reduce inflammation.

From my Spanish nurse I learned about special plasters that can help treat scarring. There are several brands: what I bought is called Trofolastin Elasticity, Reductor de Cicatrices by Novartis (made in the UK).  Apparently they protect the scar from the sun, help lock in moisture which is needed for recovery, and stop the scar from getting wet. It's too soon for me to say, but this seems to be consistent with the medical literature, which says that leaving the scar uncovered and applying gels, etc, isn't as effective.

 

 

Hello All, just found this site and found discussions helpful and encouraging. Broke by dominant right wrist (distal radius) 6 weeks ago, and can see I was fortunate !! As didn't require manipulation or surgery. Fell in Non resident area so went to local A&E where they administer backslap,which was changed to fibre cast 5 days later in my local orthopaedic unit. Pain was initially managed via pain killers and now not taking any. Like many posts I have read, I initially thought the break was a 'temporary inconvenience' with cast on for 6 weeks then hey, ho back to normal. I initially attempted to work from home but realised after a week this was an impossibility as typing an email with left hand (which was also then in a brace as pulled ligament on fall) was taking hours, and was becoming distressed as brain working faster than body. OH advised I was not allowing body to rest and heal by continuing to work and to take sick. Have taken advice and Cast hopefully coming off next week and originally thought I would be immediately ok when cast taken off but now realising maybe not as straight forward.   Would appreciate anyone's experiences  of journey returning to work. My biggest fear is impeding recovery as advised by OH, as I have osteoporosis and aware now, that  management of recovery pathway is crucial for longer term positive outcomes. Also, I have had two major reconstructive surgeries on the upper right side of body  so already stiff on this side, especially shoulder and wonder if I also need to consider this in recovery plan.

Thank you for replying and yes sense I am realising all will not be normal on 'de casting'. It's reassuring reading other people's stories of recovery and mobility will return with effort. Will certainly take your advise regarding housework, sensing manipulating a Hoover will take a long while to accomplish 😆😆👍

Yes I know what you mean, albeit my husband is priding himself constantly in how good he is helping me, he still can't hide his expression of horror when I remind him changing the sheets etc is not 'a once only task'. Think he believes the 'fairy sheet changers'👼🏻 did it before