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Is the swelling of the hand inside the cast normal after 3 days of fracture?

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Hi, I am 38 years Male, 5'11", weight 84 kg. No serious illness normal BP and sugar. I fell on my back, resting on my left hand, from a height of 3 feet 4 days back and was rushed to an orthopaedic immediately. After taking an x-ray, the Dr diagnosed a simple hair line fracture in the lower arm. I can't read his diagnosis from prescription but I can tell u that I was only able to keep my hand hanging and straight after I fell down. (What I could not tell or show the doctor at that time due to severe pain was, on turning the hand clockwise, the upper arm's bone would protrude out (muscle and bone bulged out) and gave me a shooting pain till my finger and my hand would shiver till I brought it back to normal straight position).
The Dr after x-ray and physical examinaton of my left hand brought my hand to a right angle "L" position and put a fibre cast (which is rock solid) from upper arm (just avoiding the left shoulder) to my fingers.
Yesterday, while sitting I tried to lift my broken hand, whe I believe my upper arm (shoulder to elbow) turned a little inside the cast and I got a shooting pain from elbow to fingers. I immeditely had to get the upper arm back in the normal position, and the pain lasted after thatv for about 5 minutes and then subsided. From midnight yesterday, I am feeling my whole hand inside the cast, up till the finger tips has swollen, as if someone has pumped air inside. There is no pain but the hand feels stiff as the skin is now air tight against the cast. I would like to know if I only have a hair line fracture or also dislocation of the upper arm bone (why did my bone bulge out)? Is the swelling of the hand inside the cast normal after 3 days of fracture?
Posted Tue, 1 May 2012 in Bones, Muscles and Joints
Answered by Dr. Rakhi Tayal 35 minutes later

Thanks for writing to us.

Since your hand has become airtight due to swelling, it is a concerning problem. It may indicates some internal bleeding or any other vascular problems.

You will need to remove the cast to save your arm from infection, blisters and necrosis.

You need to attend to your doctor immediately, get the cast removed, go for a repeat X-ray of full arm for re- evaluation of the fracture. In a hair line fracture, a bony protrusion should not be seen. Such an amount of swelling is also not expected in a hair line fracture.

I suggest you to see your doctor at the earliest. As earlier the treatment, lesser are the chances of necrosis and blisters.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Wish you speedy recovery.

Above answer was peer-reviewed by
Follow-up: Is the swelling of the hand inside the cast normal after 3 days of fracture? 2 days later
Thank you Dr Takhi. Since the last 24 hours, the swelling in my hand has come down but on and off the swelling comes around the elbow, which is the area of fracture. When I explained the same to the Doctor, he didn't want to remove the cast. According to him, as the hurt bone will heal, the swelling will subside.

I also consulted another doctor, he was also not very bothered by the swelling. But he also wants to take the cast out and put a smaller cast (from a little above and below the elbow).

Looking forward to your prescription once again.

Answered by Dr. Rakhi Tayal 56 minutes later

Thanks for writing again.

If the swelling has now subsided and your fingers are moving without any pain in the full range, then you can continue with this same cast.

Any cast smaller than the present one will not provide adequate immobility required for proper healing.

You can get a check X-ray done to evaluate the current condition of the fracture.

Hope my answer is helpful.

Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by
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