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What does this X-ray report indicate?

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Posted on Sat, 17 Dec 2016
Question: I fell from a chair 5 days back and fractured my right elbow. the doctor diagnosed it as a radial head fracture with minimal displacement.One doc suggested that I do a surgery and put a screw. I saw another doc more experienced and he said surgery is not required and it can do more damage than help. He put me inside a full arm cast and asked me to wear it for 3 weeks. I wanted to know where the recovery will be faster , with or without surgery. If I have to wear this cast for 3 weeks , will it take much longer to get full ROM of wrist and elbow. Also while I am wearing the cast can I move my shoulders up and down. Can I flex my hand muscles. Anything else I can do that will help me recover faster. I am a software guy so need to work a lot on the computer so quick recovery is essential for me. X-ray is attached.

Thanks for your help
XXXX
doctor
Answered by Dr. Mahaveer Patil (21 minutes later)
Brief Answer:
Conservative treatment is the best option

Detailed Answer:
Hi XXXX,

Thank you for posting the question.

I have gone through your question and the attached X ray.

Luckily,the fracture is very minimally displaced and surgery is not required.

With surgery,the recovery won't be faster compared to plaster cast. Both the treatment options will have almost similar recovery period.

Infact,putting a screw inside will give you a foreign body sensation untill you get it removed.Above it,you will require another surgery for the screw removal at a later stage.

Stiffness of elbow will be more with surgery.

So,best option for this kind of fracture is conservative plaster cast for 3-4 weeks.

If good physiotherapy is done after cast removal,full range of movements will be achieved.

You can move all the joints outside the plaster,including shoulder and small joints of the hand.

For faster recovery,you can eat calcium tablets daily- 500 mg,once daily for 1 month.

I hope the answer is useful.

Feel free to ask if you have any other doubts.

Thank you.

Kind regards.

Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Mahaveer Patil (38 minutes later)
Thanks a lot doctor. Will you suggest stretching the wrist inside the cast.Also the wrist area and hand feel very tight by the cast.Is it normal or should the cast have allowed some freeness of the wrist considering the wrist is not injured. initially the doc has said 1 roll of synthetic cast but finally put 2 rolls instead.Is the heavy closed feeling because of the extra roll
doctor
Answered by Dr. Mahaveer Patil (15 hours later)
Brief Answer:
query answered

Detailed Answer:
Hi XXXX,

Ideally,wrist has to be included in this cast.Even though,wrist is not injured,wrist does comprise of the distal end of radius bone.

Keeping wrist out of cast will allow the radius bone to move causing referred movements at elbow and this in turn may cause the fracture to get displaced.

So,wrist has to be included. This will cause some amount of temporary stiffness in wrist too,but eventually it will be free with exercises. You can move the wrist inside the cast as much as u can.

Doctor may have put 2 rolls of cast as one roll may have not been strong enough.
But even 2 rolls of plaster won't make it that heavy.

The heavy closed feeling may be because of the restricted elbow and wrist movements and this does happen to everyone when you are in a cast.

So do not worry.

You are on the right track and will be fine soon.

Thank you.
Above answer was peer-reviewed by : Dr. REMY KOSHY
doctor
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Follow up: Dr. Mahaveer Patil (4 hours later)
Thank you doctor. one last question.I was prescribed below medicines

fevram-p - 5 days - daily 2 tablets
inflam-br - 5 days - daily 6 tablets

the course is over. Should i continue with any medicines above. if not in case of pain/fever can I take paracetamol.

Thanks
doctor
Answered by Dr. Mahaveer Patil (2 hours later)
Brief Answer:
Query answered

Detailed Answer:
Hi,

At present if you have no pain,then you can stop fevram-p and inflam -br.

Start taking calcium tablets as i had mentioned.

For occassional pain/fever,you can just take paracetamol,as and when required.

Thanks.
Above answer was peer-reviewed by : Dr. REMY KOSHY
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Answered by
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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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What does this X-ray report indicate?

Brief Answer: Conservative treatment is the best option Detailed Answer: Hi XXXX, Thank you for posting the question. I have gone through your question and the attached X ray. Luckily,the fracture is very minimally displaced and surgery is not required. With surgery,the recovery won't be faster compared to plaster cast. Both the treatment options will have almost similar recovery period. Infact,putting a screw inside will give you a foreign body sensation untill you get it removed.Above it,you will require another surgery for the screw removal at a later stage. Stiffness of elbow will be more with surgery. So,best option for this kind of fracture is conservative plaster cast for 3-4 weeks. If good physiotherapy is done after cast removal,full range of movements will be achieved. You can move all the joints outside the plaster,including shoulder and small joints of the hand. For faster recovery,you can eat calcium tablets daily- 500 mg,once daily for 1 month. I hope the answer is useful. Feel free to ask if you have any other doubts. Thank you. Kind regards.