Shattered Distal Radius

Hi Jeannette54   I am a newbie. My accident was only last week and I still haven't seen an orthopaedic doctor (Friday). Mine is different in that it is just a simple fracture not shattered. I am interested to read what some say about using painkillers. I haven't taken any for two reasons. 1. I am not in much real pain at the moment just discomfort. 2. If I do take them, i will try to do too much with the hand/wrist before it heals.  I imagine that I will get a more permanent plaster on Friday. I really want to go in to work next week, even if I don't do certain tasks.

At the moment i have no real difficulty in doing small tasks like teeth cleaning, fastening buttons, holding a mug of tea but perhaps this is just because I have the plaster on. 

Have you tried applying an ice pack to your arm--anywhere, really.  I had these awful sensations that pain meds would not do anything for, and I found that "distracting" my arm with the cold would provide some relief.

In good news, these sensations stopped by about the end of week 6, so you may be almost there

Well said.......& the key is patience

Haha. I'm running a little short on that lately. Any suggestions where I can buy some? ;p

How are you doing now Anna? Your fracture and treatment sound similar to mine with both bones fractured and open reduction surgery. Unlike you though, I was in a removeable brace from the outset and never had a cast.  My wrist is very stiff and I'm struggling with both flex ion and rotation so I'm interested to hear if you've made good progress yourself 

Oh, Sally, I feel your pain.  Literally.  It sounds like we are very similar right down to the intra-articular fracture.  I had my surgery six months ago today.  And I have good news and bad news for you.

The main thing you should know is not to compare your recovery progress to those folks with nice clean breaks (i.e. not intra-articular fractures), even where they also had the surgery.  The involvement of the joint in the injury and recovery is a total game changer.  I've encountered lots of people who were back to normal in a couple of months, but that has not been the case for me.

On to the good news.  I have nearly full function of my hand back, aside from a small loss of wrist extension.  The numbness went away after about 3 months, and by 4 months, I could fully move my thumb, make a fist, and give people the finger again!  By the end of month 4, I was starting to feel like I was getting back to normal, and it stopped feeling like I had rusty nails in my wrist on rainy days.

Getting there was not easy, though.  All said, months 3 and 4 were the worst of it.  I would do it all over again because of where I am today, but there were plenty of tears and frustration along the way.  I was extremely diligent with home exercises, and I did more than what I was supposed to--I was really worried I would never get use of my hand back.  I went to physio weekly starting a couple days after my brace was removed, and let's be honest, it was pure torture.  The physiotherapist would spend 15-30 minutes manipulating my wrist, and I would end up in serious pain for 3-4 days afterwards.   

After my AHS physio coverage ran out, I changed to a different physiotherapist under my private coverage.  At this point, I had nearly full range of motion, so he only needed to work on my wrist extension.  This involved him "massaging" and manipulating the entire joint between the ulna/radius and the carpal bones.  He also worked on breaking down the "capsule" that formed along the joint.  It's a bit of scar tissue that formed over the joint.  You should know where I mean because I'm sure it's causing you pain right now.  I saw him almost weekly for another 6 or so weeks.  There was still some pain involved in this, but nothing like the first physio.  I was discharged from physio less than a month ago because there is no more scar tissue to break down.  I am at about 90% extension, and 99-100% on every other movement.  I still have a regimen of home stretching and resistance exercises to do.

On top of that, I was seeing my massage therapist at the same time for scar tissue release on my incision scar.  Excrutiating was the only way to describe it, but before I had that done, I could feel my scar pulling all the way into my hand, which was also limiting my extension.  I'm done with that now and have full movement in that area, so I'm glad I got that done, but it's hard to recommend it as a treatment.

So, the bad news.  Even though I have pretty much full use of my hand back, I am still working on regaining the strength in my wrist and arm.  I can do most things, including swimming, stationary rowing, and light yoga (including cobra pose),  but lifting and pushing can still be a challenge for heavier amounts of weight and the angle involved.  I also have what I'm calling "frying pan arm", which is difficulty tipping things out of a frying pan onto a plate, though this is improving over time.  The muscles in my arm, all the way up to my shoulder, are still quite weak.  I'm not super worried about this, though, and I am confident that this will improve slowly over time.

The main problem is the pain.  If breaking the wrist was a 10, I am still at a near constant 2-4, depending on the weather.  I have a built in barometer now where the thumb meets the radial bone, and I can predict rain to about a 90% accuracy.  Now that the weather's turning cold, my arm, wrist, and hand often just ache at a low level.  Different spots hurt depending on the day--sometimes it's my hand, sometimes it's my forearm near my elbow.  I still take Rx painkillers a few times a week, but they don't really help much.

So because of the pain, I often don't do my strength exercises.  It's a bit of a vicious cycle now.  My muscles hurt because they're weak and everyday activities strain them.  Strength training would help them be less strained, but they hurt too much to do the strength training.  I'm trying not to be too hard on myself about this and just do them whenever I can.  I've accepted that this is going to take some more time.  My surgeon told me not to expect to feel better until at least 9 months, and my physiotherapist said 9-12 months.

My advice to you would be to keep diligent with the physio, both with the therapist and at home.  You will get your feeling and range of motion back, but much more slowly than you might expect.  Joints and tendons heal very, very slowly, and they are going to be your problem going forward.  I'm sure your bones have long healed by now.  I have a couple of coworkers who broke bones around the same time as me who are long since recovered.  It's hard not to get discouraged, especially when it seems like more than enough time has passed.  There is also a balance to find between giving your wrist rest to heal and working it to get it back to normal.  At one point, I told my physio I was going to quit and asked him to talk me out of it.  He gave me a couple of weeks off, and then I went back.  I'm glad I did.

I hope this gives you some hope.  I had to rely a lot on the experiences of others for a while to keep me going--there were many dark days where I thought I would never get better.  Let me know if you have any questions.  I'd be happy to answer whatever I can

Hi Anna, thank you so much for sharing your past six months recovery story. It's great to hear that through perseverance with your physio sessions you're back to doing most of your pre-fracture activities at the six month stage. I'm sorry that you're still continuing to experience a continual lower level of pain which has been holding you back from building up your strength though.  As you rightly say, it's a question of time. The doctor told me that it would take a year to get back the movement in my wrist and then It wouldn't be to the degree of flexibility before the fracture - not what I wanted to hear! 

I'm interested to know whether you suffered a left or right wrist fracture. Mine is the left and fortunately I'm right handed. You seem to have achieved much better pronation/supination than me in your previous post at eight weeks. I'm nearly at the six week stage and can still barely pronate more than 10 degrees from neutral, although supination is easier.  Extension and flex ion movements are also very limited at the moment.  My fracture was distal radius (intra-articular and comminuted - 4 pieces) as well as the ulna styloid which is the very outer top notch of the bone. My physio showed me my x-rays a couple of days ago and it was a nasty dramatic looking fracture as a result from a trip on a paving stone. I'm going to be given a DEXA scan on my next hospital visit to check my bone density (I'm 57).

Was your ulna fracture a bit further back towards the elbow or at the styloid process like mine? I have very prominent ulna and when I fell this bony bit appeared to have been grazed, but I'm now not sure whether the lesions were coming from under the skin due to the broken surface. As a result this bony area has had a really painful lesion on it that was made worse by pressure from the bandaging and splint. I had to make myself a foam pad to keep anything from pressing on it and it has only just healed over fully at long last, although it feels like it's still an open sore when I do certain exercises and the skin is moving over the bone. Ugh! That and the stiffness that feels like my wrist is being held in a steel cuff when I try to do my exercises. 

I'm glad to hear that the numbness you had is now gone. I really hope mine improves as at the moment it feels like I have a large sticking plaster over the lower area of my palm going over to the base of my thumb and down to the top of my scar. My physio (self-funded as there has been no indication from the hospital so far that I will get any physiotherapy) massaged my scar to mobilise the tissues on my last session and I'm supposed to do it myself which I find difficult - not pleasant but I can appreciate that it may otherwise hamper wrist movement.

I'm interested in hearing when/if you've started driving again. I can't imagine that I'm going to have the capability of pulling on a handbrake for months so wondering if I should change my manual car for an automatic with electronic handbrake so I can resume driving sooner. Fortunately I can walk to work so I can get away with not driving most of the time.

I certainly notice weather makes a difference to pain levels and going towards Autumn with falling temperatures has made me feel the need to look for some kind of insulated wrist band for comfort (though perhaps that's the wrong word!). 

I have my follow-up appointment at the hospital in 9 days when I get to see the surgeon and presumably have another set of x-rays taken.  I hope I'll be told that everything is healing as it should without any new complications. Yes it's hard to imagine that my arm/wrist/hand is ever going to feel "normal" again at this stage but I have to hold on to the thought that every day that passes is a day closer towards it.  😊

 

Sally I am shocked that you have not been referred to a physio at the hospital. Why don't you ask about it/put some pressure on the consultant when you go for your next appointment ? As I read your account, I thought that I would not have been able to afford regular private physio sessions if my injury had been worse and I had needed them. Where in the UK are you?

Hi Kate, my situation is a little tricky because I was operated on in Portsmouth which is where I fell on a day out, but I actually live about 45 minutes drive away in Winchester. It may be that when I go for my follow-up next week I will find out that the Portsmouth hospital is intending to offer me physiotherapy. However it will be difficult for me if they do because I can't drive and it's not easy to get there on public transport. I've got an appointment booked with my GP in a couple of weeks and will ask her whether she will agree to me having physio sessions at my local hospital. I did ask if my treatment could be transferred to Winchester a few days after my fracture, but my Dr said that the hospital where the surgery was done like to follow up so I don't know whether I'll get anywhere. So rather than wait and follow a printed sheet of exercises that were issued to me at my first follow-up, I decided to take things into my own hands and find a physio myself - I have a third session booked and yes it is an expensive business to go private but I don't know how long I'd have to wait for an NHS physio and the sooner the physio starts the quicker the recovery.😧

How annoying! I can see that this makes things more difficult. I would have the same problem if I had a similar accident away from home. It seems crazy to me that they didn't refer you to a hospital in Winchester.

Really for physio you should have been referred to a local hospital if the offered the service. I snapped my hand off  cycling in North Yorkshire and had to insist to be taken to Darlington A&E 30 odd miles away but one of the closest. Had a excellent job done to plate it when I returned the next day, however once the cast was removed a fortnight later the first thing they did for me was to arrange my physio at my local hospital in Bishop Auckland. I only had 2 appointments about 2 weeks apart then I was told just to continue with the excersises and that I needed no more help. Really it was only the first visit when my physio got hold of my hand and forced it to move making it crackle a little that he did anything that I couldn't one I was instructed what to do.

I probably could have been dealt with in Winchester if we had driven all the way back there and then sat around in A&E, but at that time I just wanted to get my wrist fixed so had to be hospitalised away from home with the consequences of now having to travel for appointments.  I went to see my GP today for the first time as I wanted to ask whether I could have any physio sessions. I assumed she had seen my x-rays but she hadn't so I showed them to her on my mobile. It does surprise me that there is little information shared by the different areas of the NHS. She did say that it was a really bad break looking at the x-ray but when I asked about physio she said that I just had to start moving it! So it seems to be a postcode lottery as to whether physio is offered as many people here seem to have got something to help with rehab. If I had been treated in Winchester maybe I would've got a physio referral, but obviously it's not forthcoming through my GP so still have to do my own thing. 😕