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Fractured radius and ulna, doesn't seem to be healing....?

Well I already saw an orthopedist (a week after the incident) and he took x-rays, put the cast on, etc.  Basically, my radius (right arm) was fractured near the wrist, almost to the point of breaking.  And the ulna (right arm) was slightly fractured, about halfway through the bone, right near the ulnar styloid, and it made a very disgusting protrusion in that area as well.

He put a cast on, gave me 20 Darvocets, said the pain should subside within about a week, and said I should be able to write and do normal activities, aside from heavy lifting or anything else that may put stress on it.


That was about 18 days ago, and it still hurts alot.  The pain isn't really a throbbing, its hard to describe but it feels kind of like my wrist is being crushed.  Most nights I wake up a few times feeling like the cast is squishing my arm, even though it fits just fine... And writing (I'm in high school) is pretty excruciating, and it aches for several hours after school.  Well, it really only hurts from alot of writing, like writing activities in english class, and I have a writing activity almost every other day, and they're usually a page long (10 mins. of writing).

But, my parents are concerned that video games are the cause of the pain, but honestly it doesn't hurt or ache afterwards.  Since I can't skateboard with a broken arm, I usually stay at home most days because me and my friends don't do much besides skateboard, and I would be really bored just watching them skate.  Ergo, I just stay at home and play video games or watch movies, and obviously do homework.  When I play video games though, it doesn't really involve moving the wrist, its just the index finger and the thumb required, mostly the thumb, I've noticed a little bit of the cast has broken off/loosened on the palm side of the thumb.

I really don't know if this could do much, but when I use the computer, I rest the cast on the end of the desk, and my hand is kind of lowered to reach the mouse (only comfortable position) and it does put a little bit of downward pressure on the wrist, but not to the point of severe pain/aching.

I do avoid as much use of my right arm as I can though, I've got pretty good with my left hand for daily things (I'm right handed).  For the pain, since the Darvocet ran out after a week, I've burned through 2 bottles of Advil and 1 bottle of Tylenol already, I take roughly 1600mg Ibuprofen and 1500mg acetaminophen every day (spread throughout the day obviously).  But, that hasn't helped much except temporarily.  I'm considering either taking Aleve, or asking my general physician for something a bit stronger.

So, I'm just concerned that something is preventing the bones from healing, because it feels just as bad, or sometimes worse than it did at first.  And I need some advice on what activities would cause this, so I can avoid it as much as possible over the next 2 weeks when I have my follow up to remove the cast.  I guess I'm just worried that it still hurts after 1 week in a splint and 2 weeks in a cast, it doesn't seem normal to me, but I'm no doctor, haha, so here I am asking for advice.


Thanks-
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Avatar universal
plz i want to know when should the bone start to heal after my surgery with synthetic graft wich was from 23\4\2014 ?? thank u
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Avatar universal
i want to know is smoking cigarette(tobacco) has bad effect on synthetic bone paste ? What are the food and medicine that can be taken to help the healing? plz ..... and  thank you too much
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Avatar universal
i did the surgery yesterday (plate and 6 screws for ulna ) idon't know i think 6 screws too much ! ! anyway it was very very painful and i still feel this pain but the problem that i see my elboew and my fingers is swelled  the doctor said its because the surgery and he said keep your finger in movement but i fear from that swelling speacially which on my elbow  plz give me an advise ? and if this pain after surgery take to long time ?

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Avatar universal
Hi!

I hope your pain has subsided! Your Ortho Doc has his/her own protocol on treatments. I (Orthopedic Surgical First Assistant) have assisted on hundreds of these procedures.

The benefits of using a synthetic graft is, of course, alleviating the additional incision over your Iliac Crest. Keep in mind that bone has no feeling.

I prefer not to comment on my personal choice because I have seen successes (and failures) in both scenarios.

Please keep me updated (if you have time) on your progression.

Have a Great Day!  JD1963







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Avatar universal
thanx alot
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Avatar universal
some doctors said it need scraping  then bone grafting from the bone of pelvic and one doctor say to me it just need internal fixation with tri calcium phosphate (synthetic bone graft) if need and no need  to take bone from the pelvic for my case as he consider 2 months not too much for the graft and he who i'll do the surgery with  do you think it need bone grafting from the pelvic??
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Avatar universal
Hello and Welcome to MedHelp! I am the Orthopedic Community Leader for this website. If you still have a non-union after 2 months, unfortunately, surgery is your only option if you want a properly functioning arm. I can only give you my personal opinion, so always consult your physician on any future decisions. The problem is that the bones have now formed a pseudo cartilage on the ends. This will prevent any future fusion. What needs to be done is a curettage (scraping away) of that substance and a ORIF (Open Reduction Internal Fixation). This will allow the bone to heal in the proper alignment. If you have any further questions, please feel free to contact me! Best wishes! JD1963
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Avatar universal
plz i need help im 26 yeas old and i has ulnar fracture in the lowe third i didn't make surgery till now the fracture was from 2 months and till now not healed and now the doctors say it need surgery i put gypsum (plaster) among the 2 months but now not healed plz what can i doo
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2177241 tn?1337557273
How is your wrist now?
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Avatar universal
Well my surgery is in 2 days... I'm a bit nervous and stressed as it's my first surgery besides wisdom teeth but I'm sure everything will be fine.  The doctor is very well known around Tucson as the best hand surgeon, and all the physical therapists at the place I've been going to say things like "if I had a wrist problem, I'd see him about it" - so I feel rather confident in his ability.

The pain has actually escalated to a great extent... Last night I couldn't fall asleep until about 3 a.m. then woke up at 5 a.m. and couldn't get back to sleep due to the throbbing pain.  At the consult for my surgery though, he wouldn't give me any weak pain meds (like Darvocet which I took for the original injury, didn't get me "high" - only helped the pain); and he wouldn't even give me a 600-800mg prescription for ibuprofen...?  Last time I checked, ibuprofen isn't abusable, but whatever, I'd hope he's giving me a real painkiller for post-op.


Anyway thanks for the help, and wish me luck!?


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Avatar universal
Update:  


Well things are finally falling into place, I think...

The hand surgeon ordered an MRI of the wrist, and the radiologist's report of the scan said "on the triangular fibrocartilage complex.... consistent with a tear".

The PT showed me the TFCC and described it, also said that "consistent with a tear" could mean many things - but needs to be determined by the hand surgeon.


The physical therapy is going.... okay.  I've got alot of my strength back; my biceps, triceps, lats, pec's, and delt's are all much stronger after only 3 weeks (~8 sessions).  Isometrics also strengthened my forearm (right) a lot.  However I'm not sure if my range of motion has got any better - it might be even worse...  

But pain, is becoming a problem.  The PT recommended that I buy a spica splint, and lol no store in town knew what that was (spica is the proper name) - but I found one that was good for what I needed.  I use the splint during most of the exercises, and it keeps the wrist stabilized, but even with low weight during the exercises - there is still a lot of pain involved.  I do isometrics everyday, ice everyday at least once, and take all the OTC painkillers I can safely - yet my wrist still hurts BAD.  I mean about as bad, if not worse, then when I broke it.  It varies from day to day but right now, it's an "8 out of 10" - seriously bothering me and keeping me awake right now (I have school tomorrow).  I also have to take breaks in school b/c it hurts too much to keep writing...  

I usually take (roughly every 3-5 hours): 600-1200mg Ibuprofen & 1000-1500mg Acetaminophen.  And of course, I ice it whenever it hurts and I'm at home... I sleep with the brace on.... basically, I do the most I can to reduce the pain, but it seems to have no effect.

The only thing that's temporarily helped the pain is iontophoresis after the physical therapy session, and sometimes icing it numbs it, but doesn't help the pain..



So, any thoughts on what the treatment might be?  including pain management, how long it'll take, the options, etc.


  The guys at physical therapy are all young and funny so I have a pretty good time while I'm there too.
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Avatar universal
Well, its now been 6 months since I broke it, and it feels about the same if not worse...


I scheduled an appointment with a hand surgeon, waited 5 weeks for an appointment on the other side of town, then they delayed the appointment another week.  The appointment was rescheduled for last Friday (4 days ago), but on Thursday we got a call from his office saying his wife is in labor and he can't see any patients for another 2 weeks.  Then the receptionist said I could come in anyway and see a "physician's assistant" because she supposedly worked with the real doctor for a while.  I didn't really care, I just wanted somebody to look at it...

She took new x-rays and compared them to the old ones (exactly 6 months ago), and it looks like the bones healed fine.  But that really doesn't help, because there's clearly something wrong.  I'm up writing this at 4 AM on a monday, because the pain in my wrist has been keeping me up for the last few weeks.

So while looking at the x-rays, she said it "looks okay" but there was a very noticeable spacing between the ulnar styloid and the wrist... Actually I can see it just looking at the top of my wrist, the styloid further toward the hand, a little off to the ulnar side, and its bulging out in a pretty disgusting manner.


She did other tests like the grip thing, and my right arm USED to be much stronger than my left (I lifted weights alot prior to this injury), but now my left arm is about 15-20% stronger than the right.  Then she took measurements of the angles of my wrist's motion, but didn't say anything (???)... Then tried moving it around but she couldn't get it to click, so I demonstrated how to make it click, theres about 4 different clicks if I move my wrist around in a circle, and a loud click if I move my hand upward (extending).  

For a while it was just some pain when doing activities that used my wrist/arm but now it hurts for no reason... and I've taken as many OTC painkillers as I safely can, but still no help.


At the end of the appointment, she gave me a referral to physical therapy, and said she'll talk to the doctor about whether or not I need to get an MRI done to check the ligaments... But I don't think this will even happen for 2-3 weeks since the doctor is so busy, I understand he has family things to take care of, but its really aggravating to me because I waited 6 weeks for the appointment, and he doesn't show up - instead, gives me a young girl who didn't really know what was wrong, only knew how to do the tests...


And other things that have changed:  I don't get the "tingling" much anymore, but alot of times my hand just goes completely numb and I don't notice until I try using it... Probably other things, but I can't think very well this late at night...

Please let me know what you think the problem could be -

thanks.
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Avatar universal
Hi,
I feel your symptoms are indeed due to Carpel tunnel syndrome or ulnar nerve compression at the elbow joint.
I think a hand surgeon would be appropriate if you have one around and if not then you can see an orthopedic surgeon for further evaluation.
An imaging study of the joint is important which should include MRI study to see for soft tissue pathology.
Keep me posted if you still have any queries.
Bye.
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Avatar universal
The pain is specifically below my ulnar styloid, below meaning away from the hand, towards my elbow; about in the center of my arm, in terms of depth...


As for the symptoms, when it happened twice that day I posted, it was extremely painful and sharp, electric in a sense because it did feel like an actual electric shock... and after those 2 jolts, it was just kind of achy and numb/tingly.  

I haven't had that terrible pain since then, but I do notice my whole hand/wrist going numb if my hand is angled anywhere >45 degrees, it hasn't gotten to the point of going completely numb since I do notice the tingly/numb feeling when it starts doing it...  


I'm a student now, not working, I skateboard most days out of the week but I haven't fallen on my injured wrist since I first broke it.  In spare time at home I play video games, not excessively but almost everyday I think.

When trying to sleep I can sometimes feel it going numb, but I just position my arm differently and it goes back to normal.  Although I have woken up at normal times (not in the middle of the night or awoken because of symptoms) and noticed that it's completely numb, but that could just be from sleeping on it or something.  However I take a pretty high dose of ambien every night, so even if I did wake up from it, I doubt I'd remember (I rarely remember being woken up by somebody if I go back to sleep).


As for treatment, the day that bad pain happened, I lightly wrapped it with an Ace bandage, at first it seemed too tight and made it feel even more numb, so I loosened it.  But I haven't wrapped it since that day.  I've taken 400-600mg ibuprofen whenever it feels achy, and that usually makes it stop.


That's about it.........  Who do you think I should see about these new symptoms though?  We have every type of doctor within 10 miles of my house, and insurance covers nearly everything, so I'd prefer the best possible choice.
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Avatar universal
Hi,
I think your symptoms are classical of neuropathy. Neuropathy might be due to nerve compression or nerve irritation.
Your symptom suggests that you might have Carpel Tunnel Syndrome.
I would like to know little more before we are sure of diagnosis.
Where is your pain exactly if you have to point out with an index finger?
What is the quality of your pain and/or symptoms (e.g., sharp, electric, dull, aching, numbness, tingling, etc.)?
What are your occupation and hobbies? Do you ever have symptoms at night that awaken you from sleep? Have you tried any treatments for your pain and have they helped?
Keep me informed.
Bye.
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Avatar universal
okay well now im a bit concerned, i was just sitting at home, and i reached down for my xbox controller on the floor, and out of NOWHERE there was a awful electricution-like feeling, kinda like those prank shockers, but about 5 times stronger, and when it happened, i jerked my arm up and shouted cuz it hurt really bad....  it felt a bit strange, but i reached down again, and it happened again..  the pain was coming from a little bit below the wrist, basically where the break in the arm was.

and now its pretty numb and tingly, dunno why.


but it was only from reaching downwards




what does this sound like it could be?  is this a common symptom of anything?
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Avatar universal
Horsetail an herb is great for healing fractures.
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Avatar universal
Hi,
The pain pattern and its distribution suggest that it might be Carpel Tunnel syndrome (CTS).
CTS is a neuropathy caused by compression of the median nerve within the carpal tunnel.
A symptom what patients have is weakness or clumsiness in the hand, pain in the hand, wrist, or distal forearm, and awakening from sleep with pain or numbness in the hand.
I think you should get an imaging study of your wrist and hand.
A visit to orthopedist is helpful.
You should be consulting a physiotherapist even if not referred by orthopedist.
Keep me informed if you have any queries.
Bye.
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Avatar universal
I'm 17 and healthy, I exercise almost regularly, and I'm not depressed or anything, I have plenty of social time, so mentally, I'm fine.  Sleep is really my only medical issue, but I've had problems with sleep for 3 years so I don't know if thats really a possible underlying-cause.


When I had the cast it was very painful and throbbed basically 24/7...  I only had 1 week's worth of Darvocet, so after that ran out, I took 800mg ibuprofen/1000mg acetaminophen every 4-6 hours, everyday for about 3 weeks or maybe more.  My point is, my friends would always want to go out, and mostly all they do is skateboard, so that was out of the question... and I felt pretty irritable anyways from the pain and sleep disruption from the pain.

I'm not on physical therapy... the orthopedist took the cast off, he just said "don't fall on it, take OTC pain meds when needed, and call me if it still hurts after new years [a month after], goodbye."  I don't smoke cigarettes, but I do smoke marijuana habitually at night.  


Okay questions answered, basically, I'm wondering what would be better: going back to see the orthopedist (seemed dismissive/didn't care, probably b/c most of his patients are elderly from what I noticed) or just going to physical therapy.  I mean would the ortho just send me to physical therapy anyway?  And what could the problem be that's causing the pain... just concerned...

thanks-
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Avatar universal
Hi Cactus,
How old are you? How are you feeling otherwise?
What activities you have resumed or are able to do since the removal of cast?
Are you on physical therapy?
Are you a smoker?
It takes time to heal, 3-4 months is normal expected time for recovery.
Pain killers would help you for pain.
Physical therapy would help you in increasing range of motion around the joint.
Smoking and high dose of pain killer would inhibit bone healing hence it should be avoided.
Keep me informed if you have any queries.
Bye.
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Avatar universal
um well its been 3-4 months, and it still hurts to pick something up with my right hand, lift things with alot of weight on the right, twist to either side, etc.

not terrible pain, but enough to make me drop whatevers hurting it

the only time it got a LITTLE bit better was 2 weeks after getting the cast off
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Avatar universal
im 17 - 6"0' - 190lbs

the accident was skateboarding, about 3 weeks from today...  I didn't have any trauma to it, that I can remember atleast... Maybe a little at first because I didn't know it was broken and I tried to just do daily things, but it hurt ALOT and started bruising all along the side of my arm, which is why I got it checked out.  


For pain I'm gonna try Aleve for a few days to see if that helps, I know it helped my back when I had a job over the summer and did alot of lifting, so maybe it will stop the aching, idk.  If not, I may just ask for 2 weeks worth of Darvocet, when I took it 2 weeks ago it completely helped the pain, but didn't have the strong euphoric/sedating effect.  

Yeah the follow up with the Ortho is on the 30th, but I still want to know if it's normal to have this bad of pain 3 weeks after the injury...
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Avatar universal
Hi,
can you say how old are you, when you met with accident and what you did after it because you had consulted the orhtopedician a week later. As far possible try not to move your hand eventhough cast is in place as it can cause more pain due to movement of the fractured segments of bone and may also cause soft tissue daqmage. you have to wait for 2-3 weeks more  to see much improvement so don't worry much  and take combination of both Brufen and Acetaminophen 3 times daily to get relief of pain. Consult your orthopedician for review and repeat the x-ray.

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