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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Shattered Distal. Did Surgery. Have Limited Supination, After Stretching And Therapy. Limited Flexion. X-ray Shows Slight Gaping. Problem?

I shattered my distal radius 10 weeks ago due to a biking accident and had surgery with a plate and several pins the day after the injury. I got the cast off 3.5 weeks ago and have made some gains with ROM, but my ortho doc is still concerned with limited supination (35-45 degrees after stretching and therapy) and also limited flexion (feels like hard end feel possibly due to hardware to me)... digit movement improving, wrist extension 10 deg from that of the uninvolved hand... But he mentioned at last visit based on my limited movement (3 weeks out of cast) and x-ray showing very slight gapping- that I may have also torn my scaphoid ligament and so he suggested seeing me again in 4 weeks and if no improvement ( guessing he is hoping nearly 80-90 % rom) then he will do further testing and may have to go in again and repair that ligament...OF course I was not happy. I am struggling to see any benefit of a second surgery and 8 weeks immobilization when I still am lacking so much rom which will only make it worse. I should say I am a PT and am pushing this is much as I can just not sure what else to do. Any thoughts on this? I am looking into Joint active system to also help stretch to gain adequate ROM. Strength coming back slowly but steadily as is functional abilities.
Wed, 4 Sep 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

A certain amount of stiffness and limitation in range of motion is commonly encountered in comminuted distal radial fractures after any form of fixation. So you have to accept this fact.

Aggressive physiotherapy is the only hope for regaining motion in the wrist joint.

Hope this information is helpful. Good day
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Shattered Distal. Did Surgery. Have Limited Supination, After Stretching And Therapy. Limited Flexion. X-ray Shows Slight Gaping. Problem?

Hi, thanks for writing to HCM. A certain amount of stiffness and limitation in range of motion is commonly encountered in comminuted distal radial fractures after any form of fixation. So you have to accept this fact. Aggressive physiotherapy is the only hope for regaining motion in the wrist joint. Hope this information is helpful. Good day