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wrist pain following surgery to insert metal plate (Page 1)

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I broke my wrist and on advise of doctor had metal plate surgically inserted with screws. I am still having pain in my wrist on the thumb side six months following surgery. It hurts if I try to bend the wrist a certain way, or if I try to put weight on it, especially right under the thumb on the side of the wrist. The Doctor says it is not the metal plate or screws that are causing the pain, that they don't look like they are out of place in the x-rays, and they are reluctant to do another surgery to remove the plate. They said to go back to physical therapy but I have been to physical therapy (which has just involved doing some stretching exercises) but it doesn't seem to be helping. What would be causing the pain? Is there a different type of physical therapy I should be exploring? Should I have the plate removed? I am an active person and the wrist pain and limited range of motion is interferring with my ability to do biking, rowing and especially yoga (no downward dog at all).
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replied December 7th, 2011
wrist surgery
I am in 2nd month post wrist surgery. it seems to me that most of the pain now is from the hardware. my dr said sometimes it has to be removed. i know someone who had the removal and did much better after. if your dr refuses and you can see another-do so.
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replied December 7th, 2011
wrist surgery
I am in 2nd month post wrist surgery. it seems to me that most of the pain now is from the hardware. my dr said sometimes it has to be removed. i know someone who had the removal and did much better after. if your dr refuses and you can see another-do so.
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replied February 23rd, 2012
Even I am facing similar problem. Its been 3months since my wrist surgery (where a plate and screws are inserted for the broken bone) and offlate I am getting severe pain which is some times moving towards my fingers...
When consulted, my Doc said it could be due to the growing Tendons. I am not sure if this has to so painful... because I was quite ok all these days.
Any ideas/suggetions?
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replied February 23rd, 2012
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Divya24,

It is possible you are developing some adhesions of the tendons or your could have some inflammation of the tendons or tendon sheaths.

It takes a lot of soft tissue dissection to place a plate on the distal radius. this has to heal, and of course, it heals with scar tissue. At three months you are still within the time of healing and maturation of scar tissue, which can actually take several months to even a year.


If you are losing motion along with the discomfort, it may be that you have adhesion, scarring down the tendons. It is really important to work on not losing range of motion if you can.

If it is inflammation of the tendons or sheath, that may respond to antiinflammatory medication.


Of course, there are several other things that could also be causing the discomfort. If it seems to be getting worse, do see your surgeon sooner rather than later.


Hope that your wrist feels better soon. Good luck.
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replied February 24th, 2012
Thanks Gaelic
Thanks Gaelic,that helped me a lot.
Doc advised me some antiinflammatory medicines and I am feeling better now!.

But do you think I need to give some rest to my wrist? as of now I use it for all my daily activites except lifting heavy weights. Is this too early to use my hand?
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replied February 24th, 2012
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Divya24,

It is always a balancing act. If you do not move and use the wrist, you run the risk of it becomming stiff and weak. But, you also do not want to over use it.

You do need to use the wrist and do gentle range of motion exercises to maintain your motion and rebuild strength. So, work out type of discomfort is okay.

But, sharp, intense pain, or pain that lasts into the next day, probably means that you are doing a little too much.


Again, it is a balancing act. Don't lose the motion you have, but do not hurt yourself either.

Good luck.
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replied February 26th, 2012
Thanks a lot for your suggestions...
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replied February 28th, 2012
I have a wrist plate, 7 screws
I have had a plate in my arm for two years. 3 months is nothing! I fractured it into three peices, they set it, then had to saw it apart and reset it after it healed wrong, and now I have this plate. There is pain, yes, but I decided not to have the surgery because that is VERY painful and who knows? maybe it won't even help. In any case make up your mind now don't wait like I did; now I feel like just leaving it in. It hurts if I bang it, it gets weirdly cold in the cold, and you can feel the screws through my skin (remember in a hundred years they'll think this is medieval torturous medicine!)
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replied April 30th, 2012
Wrist Surgery that did not go well
I had wrist surgery on Feb. 14, 2012. I also have a metal plate with 7 screws. The pain that I went through was UNBEARABLE! I went back to the ER the night of surgery, because of the pain. Bad news is I still have pain and only 50% rotation in my arm. I am getting a 2nd surgery 2morrow (May 1, 2012)to hopefully get more rotation. I went for a 2nd opinion also, and there are really no answers as to why it is not healing correctly. I am just in shock that I have to have another surgery. Sad
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replied April 30th, 2012
Wrist Surgery that did not go well
I had wrist surgery on Feb. 14, 2012. I also have a metal plate with 7 screws. The pain that I went through was UNBEARABLE! I went back to the ER the night of surgery, because of the pain. Bad news is I still have pain and only 50% rotation in my arm. I am getting a 2nd surgery 2morrow (May 1, 2012)to hopefully get more rotation. I went for a 2nd opinion also, and there are really no answers as to why it is not healing correctly. I am just in shock that I have to have another surgery. Sad
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replied May 15th, 2012
Same here I had it in jan 2012 plate and 15 screws still having really bad pains and lumps have appeared on the top of my hand. The pain has only just started to come back I get really sharp pains in my fingers and sometimes can not even lift a mug. I have been trying to see someone but next appointment is not till end of june and they can not fit me in which is bad as seeing the last time I went in march he was delayed 2 hours so didn't see him. I was told it would heal fast due to having the plates but still 4.5 months later I am in so much pain but just keep getting fobbed off. I also keep loosing feeling in my index finger from time to time.
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replied May 15th, 2012
Same here I had it in jan 2012 plate and 15 screws still having really bad pains and lumps have appeared on the top of my hand. The pain has only just started to come back I get really sharp pains in my fingers and sometimes can not even lift a mug. I have been trying to see someone but next appointment is not till end of june and they can not fit me in which is bad as seeing the last time I went in march he was delayed 2 hours so didn't see him. I was told it would heal fast due to having the plates but still 4.5 months later I am in so much pain but just keep getting fobbed off. I also keep loosing feeling in my index finger from time to time.
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replied October 5th, 2013
I fell at my daughter's wedding in June, 2013 and had surgery a week later - plate w/11 screws on the radius and also broke the ulna and they both shattered. Three months later and I am still in considerable pain - sometimes sharp pain by the ulna or in the fingers or by the incision. I have been going to PT since a week after surgery 3 times a week for 2 hour sessions. I was told this was a very bad break and would only gain 75% use at best. It is my dominant left hand and typing is very difficult due to lack of full range of motion in the wrist. Still have numbness in the index finger, thumb, and bottom of palm. I now have bumps on the incision and worry the screws are popping out. I have been out of work (admin. asst.) w/o pay for 18 weeks! I am 68 and have osteoporosis and may have to retire earlier than planned due to this injury:( Any advice?
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replied May 15th, 2012
Well, I had my second surgery. Looks like my bones weren't lined up correctly in my right wrist. That was why my recovery was horrific! This recovery was 100% better, but I am still where I was before 2nd surgery. I only have 52% rotation (cannot put my palm facing up), my wrist won't flex up, and I still have pain and my wrist is just so tight. So, first surgery was Feb. 14th and second was May 1st. I'm just wondering if I will ever regain full rotation and when will the pain end?! Need to hear other people's stories of how long their pain lasted. So frustrated as I'm such an active person and can only lift a 2 lb. weight with my right arm now.
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replied May 16th, 2012
I feel so sorry for you I know how you feel i am back to not driving again now as the pain is so bad i'm just hoping I won't have to have a second op. But your problems seem to be the same as mine. Are you taking it further with the nhs for all the mess ups?
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replied May 16th, 2012
I just don't know what to do at this point. Friends tell me to contact a lawyer, but my doctor's reasoning is this surgery can be difficult and my bones were only re-aligned a couple milimeters from my first surgery. I did go for second opinion and wish now I would of went with that doctor. Because I am so small, I guess that played another factor also. I'm so upset because I have pain every day, went through 2 surgeries, and still nothing has changed (except for an easier recovery this time around). I'm such an active 43 year old woman, and this limits me. My next follow up is June 11th. I have lots of questions for my surgeon. Fyi...he put a longer plate in this time too. Lovely....
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replied May 17th, 2012
Hi I have had a solicitor since half way through my break and it's a no wo win no fee thing but they are 99% it will be a win it's been since sep 2011 since I contacted them and have been with them since and they have been a great help, you should not have had to had 2 ops it is neglagence we pay our nhs so should get the treatment we deserve take it further! Bless you it is such a downer I know I couldn't lift my toddler for 1yr due to being in a splint and on the waiting list x
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replied September 24th, 2012
My wrist is hurting 6 months + post surgery
I actually had wrist surgery to fix my broken radial bone back on March 19th, 2012. I had 1 plate and 9 screws. They surgery went really well, very mild discomfort, and I healed pretty quickly and have full range of motion. My only concern that I am noticing now is if I turn my wrist in a certain direction, I get a shooting pain up my arm. As of this weekend, my entire wrist right where the plate is, hurts. Its very uncomfortable and I dont understand why all of a sudden this is hurting again. Any suggestions?
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replied September 24th, 2012
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Courtneyvs,

Sorry about your problems.

While it is not uncommon for patients with distal radius fractures to have some aches and pains around the wrist and forearm while they are rehabbing, it is concerning that this has developed after you were doing very well.

Many patients with distal radius fractures injure the interosseous membrane (a ligament which runs between the radius and ulna bone the length of the forearm). Then, when they try to pronosupinate (turn the palm up and down) the hand, they have pain in the forearm, along the interosseous membrane (IM). The IM heals with scar tissue and it can take quite a while for this to mature and stretch out.


But, again, it is not the usual course for it to suddenly act up, after not having any problems. So, if the problem does not go away pretty quickly, you may want to have your surgeon take a look at your wrist.

Good luck.
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replied October 22nd, 2012
Wrist pain 1 yr after plate and screws
I am having the same problem, I broke my wrist in Nov. 2011, had plate and 7 screws put in. My surgery and physical therapy also went well. My wrist felt great for about 4 months and then in June 2012 I started having pain with the smaller movements. I saw my doctor in August and he prescribed prednisone, which did not help. My next appt he gave me a cortisone shot and prescribed relafen, also did not help. He did not see anything on the xray that might be causing any problems with the plate, but he said to eliminate the variables we could remove the plate if the pain was causing me that much discomfort. I decided that is what I am going to do, my hardware removal surgery is sceduled for Nov 30. I'm hoping this will alleviate the pain, if it doesn't, at least now they can do an MRI to see if there is any problems with the soft tissue.
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replied May 1st, 2013
pandorsbox,

Did you have the plate removed and if so did it make a difference? I had surgery 9/12/12 and now have to decide whether I want the plate removed. I have wrist pain and two doctors said it "Might" help to remove the plate. It would be good to hear from someone who's done it already.

Thanks.
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replied May 1st, 2013
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StopHurtingNow,

I do not know if pandorsbox will respond to you, that was his one and only posting.

Unfortunately, unless it can be shown that it is the hardware that is causing the discomfort, there is no way to know if its removal will help.


In cases where the hardware is proud, where there are tendons snapping over the plate, the plate is very superficial and is always being hit, and so forth, its removal usually reduces the discomfort.


But, if the hardware is buried under the muscles and it cannot be shown with any certainity that it is actually the hardware that is the source of the discomfort, then it probably won't help too much.


Unfortunately, many patients form abundant amounts of scar tissue around the wrist when they sustain a significant injury (no matter how it is treated). But, when surgery is added in, they form even more scar tissue. If it is the scar tissue that is causing your discomfort, then having further surgery to remove the plate would just make it worse.

If there is not an abundant amount of scar tissue, and you want to try to see if the removal will help, then you will have to make that decision.

Your surgeons cannot and will not make any guarantees when it comes to hardware removal. The results are just too variable and unpredictable.


Again, if you want to go through another surgical procedure, to "see if it helps", then go for it. But do it knowing all the possible risks and complications, and with realistic expectations.


Good luck.
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replied December 11th, 2012
Severe pain 2 month after medial humerus bone cyst excision.
I have had a plate in my arm with five screws, after bone cyst excision out of medial humerus, it goes well with out pain for three weeks after surgery, then i feel a severe pain for five days then no pain for two month then more pain again,,,

So what causes my pain ?? why it appears after it leaves??
Should I Have My Plate and Screws Removed?
my physician prescribed me ( ibuprofen 600 mg per day & myogesic 2tabs daily) & said its normal & nothing to worry about the pain will leaves after awhile ,,,
now the pain get more worse despite taking the medication daily, then fight pain by injecting painkillers ( Declofenac Sodium 75 mg twice daily)...

Please any help??
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replied December 11th, 2012
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Abuzahra,

It is not really possible to tell you what is causing you pain, without being able to examine you and see your x-rays.

In the immediate post-op period, it is not unusual to have some pain. But, for the pain to return after a long period of time is concerning that there is something going on around the location of the cyst.

Has the cyst returned? If there a fracture through the location of the cyst? Has the plate become loose? What is going on in the bone, where the cyst was located?


Unless you can prove that the plate is actually causing the discomfort, it will not help to remove it. In the upper arm, plates are usually protected by a good covering of muscle and it is difficult to even feel the plate.

But, if the plate is proud or in some other way causing problems, then its removal may help.


But, you have to first make sure that the bone is completely healed from the cyst removal surgery.


Sorry that you are having problems, but you are going to have to discuss this further with your surgeon.

Good luck.
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replied December 11th, 2012
Thanks,, Gaelic..
Thank you so much Gaelic ,,

I would like to give you more information a bout my cause,
in order to help its diagnoses :

- Iam 38yo male, with 190 cm high & 100 kg wight...
- The cyst(about 2cm cubic) location is medial humerus 1.5 inch away of left elbow..
- The cyst removed through complete curettage two month ago ( Oct.15.2012), with no formation of fractures.. or enough time to return..
- X-ray images shows the plate is fine & the screws is tighten ..
- The Orthopedic surgeon return the pain cause to my access activity without healing period for the bone to rebuilt...

Thank you again dear Gaelic,,, awaiting your help,,,
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replied December 11th, 2012
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Abuzahra,

If might be that you are putting too much stress on the plate that is holding the bone.

When a large cyst is removed, it weakens the bone. Usually, in cysts like those of Giant cell tumors, unicameral cyst, or just simple cyst, when the inside is curretted out, the cavity that results is packed with bone graft to help the body to fill it in.

If removing the cyst structurally weaken the bone, then a plate will be applied to protect the bone till it is healed.

But, the plate and scews are not as strong as an unaffected bone, so it may not be able to withstand a lot of stress. You might be applying too much force across the humerus, resulting in pain.


Also, some patients have some pain in the soft tissues through which the surgery was done. These tissues heal with scar tissue, which can cause some patients problems.


As only as you do not have any fractures and the plate and screws are intact, then it is down to either the soft tissues causing the problems or the cyst has not completely healed and you are applying a little too much stress to it. Two months is not really a lot of time for the body to fully heal a cyst of that size.


You are probably going to have to back off a little on your activities. You also might ask your sugeon for a co-apt (also called a clam shell) splint) for the upper arm. These are used to treat humerus fractures, and might provide you with a little support.

Good luck.
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replied December 14th, 2012
More concern
Highly appareciate your advice & support Mr. Gaelic, hopes you stay happy & healthy ..

I would be very greatful if you could inform me a bout this concerns :

- My arm with surgery is not fully extended ( less by about 10 digrees ), will its motion be back like it was ?
- Somebody told me that " The hardware removal surgery is more risky than main ops , because the stiff fiber & tissues of the heald wound will makes the nerve hard to be seen " is that true ?
- How long it takes for semi like my curetted cavity ( no graft done ) to be refilled ?

Thanks & best regards,,,
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replied December 14th, 2012
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Abuzahra,

How long it takes for the body to fill in the defect depends upon several factors: the size of the defect, how fast your body heals, nutrition, etc.

Usually, the defect will fill in with osteoid (the soft tissue matrix of bone) in about 10-14 days. Then the body has to calcify the osteoid. Usually, this takes about 6 weeks, but the callus (new bone) at this time may not be completely mature yet. It can take another 4-8 weeks for the callus to fully mature and become incorporated into the adjacent bone of the humerus.



As to taking the plate out, it is sometimes a more difficult surgery. It depends upon how much scar tissue the patient has formed around the surgical site. The radial nerve wraps itself around the humerus very tightly in the distal third of the humerus, which is where your lesion was located.

So, if the plate were to be taken out, the surgeon would have to be very careful to disect out the nerve, to make sure it was protected throughout the procedure. Disecting out the nerve (just handling the nerve) can cause problems itself. But, it can be done, it is just very tedious. The surgery for the plate removal carries all of the risks of any other surgery, but the extra ones of: not being able to remove part/all of the hardware, and fracture of the bone when removing the plate. Plus, the increased risk to the radial nerve if there is a lot of scar tissue around it.



Unfortunately, surgery anywhere around the elbow can (and usually does) cause decresed range of motion of the elbow. In most cases, the loss of the terminal extension and flexion does not hamper the patient any. The functional range of the elbow is from around 25 to 125 degrees. Within that arc, almost all activities can be done. (The two important parts of the body can be reached; the mouth and the groin.) When the upper extremities are used for activity there are very few that require the elbow to be fully extended. When lifting and pushing, the elbow is slightly bent. So, again, the loss of 10 degrees of extension is usually not a problem to patients.

You may get it back, depending upon what the "endpoint" feels like. If it is very firm, the elbow just stops, then you probably will not get much more motion. It the endpoint is rubbery or gives way, then you probably can get more motion.



Hope you are doing well. Good luck.
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replied March 11th, 2013
Hi Mr. Gaelic,,,,

I would like to inform you that five month of my surgery passed & now (I thank Allah ) no pain at all , my elbow motion is nearly returned like it was,, the next week will be my last review ,, so thank you a lot for your help & advice ,,, good luck,
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replied March 11th, 2013
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Abuzahra,

Glad to hear that you are doing well.

Continue to work on your therapy, until you have achieved full recovery.

Good luck.
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replied April 13th, 2013
I had a metal plate inserted with eight screws on the bone near the ankle six months ago. The surgery went well but since then i still have not been able to put pressure on the leg. It is extremely painful, with no motion at all and pain especially increases when it's cold. It also swells a lot everyday. What could be the problem? Should i get the plate removed since i can feel it pricking my flesh and skin? I'll really appreciate your answer.
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replied April 13th, 2013
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Njagi,

It sounds like you have developed traumatic arthritis of the ankle joint, due to the fracture and soft tissue injury.

If you feel that the plate is causing you significant discomfort, and the fracture is completely healed, you can have the plate removed. It is another surgical procedure.

But, it will probably only affect the local feeling, and the plate removal will most likely not increase your motion around the ankle joint to a significant degree.


Good luck.
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replied May 7th, 2013
3 weeks after surgery with metal in right wrist
I recently had surgery on my dominant right wrist with a plate & don't know how many screws. 2omorrow after 3 o'clock it will be 3 weeks post surgery. After some exercises from home (insurance doesn't cover PT) so I do them from the internet. Yes, it does hurt after but have taken your advice and work slow. What else can I do? Thank you for your time.
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replied May 7th, 2013
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Girl58,

I am assuming that you are not in a splint and your surgeon has released you to begin doing therapy.

You might want to warm up the tissues before you do your exercises. This can be done with a hot shower, hot packs, bath, or a paraffin bath. Warm tissues are more pliable and stretchable than cold ones.


But, it is just a matter of getting the soft tissues stretched and moving. The best exercises are active ones (using your own muscles to move the joint). You have to be very careful when doing passive exercises (using the other hand to push on the hand, to move the wrist), especially at only three weeks out. Distal radius fracutres usually take around 6 weeks to heal.

So, you want to get the wrist moving, but you do not want to pull the harware out.


Unfortunately, the biggest determinant of whether or not the patient will regain "full" range of motion, is how much scar tissue the patient forms. And, this is not in the control of anyone. Some scar tissue is needed to heal the damage, but too much reduces range of motion. If the patient forms abundant scar tissue, then range of motion will be reduced.


Again, be sure that it is okay to be doing the exercises that you are performing. If it is okay, then it is just a matter of trying to get your range of motion back.

Good luck.
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replied May 8th, 2013
Gaelic -

Thanks but am obviously doing too much due to the pain and using ice after exercising. Not good for me as I am now hurting but 3 weeks post surgery still means I need to heal. Will watch and do more stretching before exercise as my follow up appointment is not until June 5th, 2013. If it continues to hurt then I will call to ask about it. Thanks for the ability to talk about it "G".
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replied May 8th, 2013
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Girl58,

By three weeks out, the significant discomfort from the surgical procedure should be pretty well gone. But, that is not to say that there won't be any discomfort around the injury/surgery site.

It takes about 6 weeks for the soft tissues to physiologically heal (to withstand a lot of stress). Same with the distal radius, it usually takes around 6 weeks for the bone to unite. (This can vary depending upon the health status of the patient, if the patient uses nicotine, and actually how the fracture was fixed.)

And, the soft tissues heal with scar tissue. Again, scar tissue is necessary for tissue healing, but too much scar can reduce range of motion.


So, it would be expected that you would be sore after doing range of motion exercises. But, if you are still having pretty significant pain (still needing opioid pain medicine an a routine basis), you might want to contact your surgeon before your next appointment.

Everyone's pain tolerance is different, but again, usually by three weeks out, there will be soreness about the wrist/distal radius, but it should not be nearly as bad as it was at the beginning.


Good luck.
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replied May 9th, 2013
Gaelic -

It is not as bad and in fact can use my fingers to type some like now with hand pointing down. I use meds at night of strong prescription if uncomfortable to help sleep. The daytime is okay for only Motrin 800 but not the stronger of what I have. I don't want to be sleepy and want it to be over NOW, know what I mean? I appreciate you more than you will ever know and thanks for being there.
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replied May 10th, 2013
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Girl58,

Occasional use of opioid pain medication at night is fine and is very common after an ORIF.

As long as the discomfort is tolerable during the day, when you are distracted and doing things, you are probably doing fine.

Again, you are only three weeks out, the tissues are still healing. Unfortunately, mother nature only works at one rate, and there is no speeding her up (you can slow her down - such as with smoking while a fracture is healing).

It will get better. Keep up with your active range of motion exercises. Hang in there.
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