Friday, June 3, 2011

Persistent Wrist Pain Following Distal Radius Fracture

Have you broken your wrist and still have experience pain with gripping and twisting activities like pouring a drink or turning a door knob? Did you believe that you have a sprained wrist, as a result?

A common problem from a broken wrist (distal radius fracture) is pain after the fracture has healed. The distal radius is commonly broken because it bears 80% of the force when falling on an outstretched arm. This is why more people break this bone (radius) instead of the other bone in the forearm, the ulna. However, although the fracture occurs at the “thumb side” of the wrist, there is a ligament complex located on the opposite side of the wrist called the triangular fibro cartilage complex (TFCC) that can be injured. Additionally, the distal radius bone can heal shorter than it once was which will ultimately produce more force though the articular disc and TFCC creating more pain.

Studies indicate that 35-50% of all patients with wrist fractures present with problems in the TFCC region. As a result, an individual who has a recent wrist fracture may begin to feel discomfort at the ulnar/pinky side of your wrist after the bone heals and they start to regain motion. People will often complain of clicking, increased swelling, weakness, and lack of motion. They have difficulty with activities such as turning a door knob/key as well as difficulty ironing, scrubbing, performing a push up, Yoga and pouring a drink.

Rehabilitation following a distal radius fracture involves the use of modalities, range of motion and strengthening exercises. How well healed the fracture is (based on x-rays) and when an individual begins physical therapy determine what exercises they should be doing. These exercises may need to be modified by a physical therapist especially when persistent wrist pain is present. Functional recovery for stable fractures without complications can be six months and 1-2 years for complex fractures. Fortunately, the rehab process does not take that long. It is the therapist’s role to educate the patient and assist them in making maximizing their outcomes both in the clinic and home setting. The goal of physical therapy is introduce the patient to all of the available tools and exercises available to manage their symptoms until recovery is complete.

The wrist is very complex and requires careful evaluation to develop a good plan of treatment to achieve maximal functional recovery. If you are experiencing these symptoms and would like to schedule evaluation with our upper extremity team please call Marylou Corcoran Physical and Aquatic Therapy (315) 637-4747.

Operation Walk

Operation Walk is a non-profit organization that allows severely disabled arthritic patients in countries with underdeveloped health care systems to receive total-joint replacements at no cost. The recipients of care are afflicted with intense and unrelenting pain with mobility limitations that make the experience of a normal and productive life nearly impossible. The goal of Operation Walk is to enable people to return to their lives as productive members of society. To date, Operation Walk has conducted successful operations in Panama, Ecuador, Russia, Cuba, China, The Phillippines, Nicaragua, Peru, El Salvador, Vietnam, and the United States.

MLCPT is proud to announce that Julie Randall, PT, CSCS, LMT will be a member of an inter-disciplinary medical team that will be traveling to Kathmandu, Nepal in November 2011, the first journey for Operation Walk Syracuse. As a member of Operation Walk, Julie will be working closely with physicians (from St Joseph’s, SUNY Upstate and Crouse Hospitals), physical therapists, nurses and other health professionals; maximizing the post-operative outcomes of over 75 joint replacements to be performed in one week. While in Nepal, she will not only be responsible for the direct care of post-operative patients, but she will also serve as an educator, helping to instruct Nepalese health care workers in the latest techniques in rehabilitative science.

As you may imagine, the cost for such an endeavor can be staggering. In the United States, the charges for one hip or knee replacement can be in excess of $100,000, with the total cost being greater than $7,500,000. Fortunately, through the donations of more than 40 professionals, coupled with donations from implant and pharmaceuticals companies, the cost is reduced significantly. Contributions continue to be needed, however, to cover $200,000 in remaining expenses for team transportation, supply shipping, food, lodging, non-donated supplies and equipment repairs. If you have an interest in helping support Julie and Operation Walk, we would encourage you to visit the Operation Walk website to make a donation.