Experiences of healing from an ORIF for wrist fracture?

[Vinculum]

I broke my wrist just over 3 months ago - a Colles fracture of the radius. It was surgically fixed with a titanium plate and screws and the surgeon was very upbeat about recovery and assured me the plate would stay in with (most likely) no problems.

I'm doing lots of physio and mobility's improving - far from back to normal though and the wrist is still stiff. My hand stiffens up, especially overnight, albeit not as badly as it did. I definitely have made big progress - but the part of my wrist where I know the plate is attached is often very sore, and when I stretch it to do my exercises (particularly flexion - bending my hand down towards my inner forearm) it pulls horribly and painfully. It feels as though the plate/screws are being put under real pressure with this movement, although I do know the fracture itself is well-healed by now.

I only had one X-ray a few weeks after the op to check the plate was OK and they were happy with it and discharged me - but should I be worried? Is this 'pulling' pain a normal thing and I should just power through it? Will it eventually go away? I'd be interested in the experiences of any fellow ORIF-ers!

Sorry to hear you are having pain. I had this operation in 2016 but it healed up nicely and I never got any pain like you're describing. Yours doesn't sound quite right. Perhaps you should speak to your GP to get referred back to the Dept that did the op. Hope you get it sorted.

Thanks @CrowsInMyGarden. That’s interesting and a bit worrying! I’ve discussed it with my physio and she's quite insistent that it’s all fine - but perhaps next time I go I'll ask whether I can be referred back to the fracture clinic to check all's well. I have read that even if the plate is causing problems they don’t remove it for a year or so, because you’re still healing for all that time…

Can I ask how quickly you regained full mobility and weight-bearing with your wrist?

I'm so sorry OP I can't remember as it was 10 years ago. I know I never felt that it was taking too long if that makes any sense.

Good to know - thanks for the info; very useful.

Hi, I had this surgery a few years ago and had a similar sounding sensation to you. It just gradually got better with physio exercises and strengthening work. I think by about 4 months the pain was very minimal and it was as strong as it was before the fracture. Now it feels much stronger than my other wrist.

That’s really helpful, @LaughingLemur, thank you. I’ve spent flipping hours searching the internet to try and find out whether this was normal but there just doesn’t seem to be much in the way of actual experiences from people who've had the surgery - hence me starting the thread!

I had this surgery a few years ago and still had quite a bit of pain after several months, though I'm not sure it was quite the same movement as you are describing that caused the pain. I had a follow up with another x-ray, and they decided the ratio of lengths of the radius and ulna was off, and did a further surgery to shorten the ulna, which has helped (not pain free but much much better).

I guess outcomes can vary wildly. But ouch, @Monetsgardenbridge - that does sound uncomfortable, and it must have felt like a setback to have more surgery. Sorry you’re still having pain.

That all sounds awful, I’m so sorry you’re in such discomfort. Not quite the same, but I had pins inserted after breaking my wrist last July. I’m still doing the physio exercises eight months later, and trying to get full strength and movement. The physio discharged me although I have the option to go back until this month. I was panicking about it for a while as improvement seemed to move at glacial speed and if I tried to accelerate the process by exercising harder it increased the pain.

It’s still quite stiff and painful but I’m not panicking about it any more as I can see that it has actually improved a lot, and am resigned that my case will be one of the ones that take at least a year to get fully functional again.

My physio always stressed that it could take a long time, and took measurements of strength and movement so I could see there was some improvement even though it all still felt useless and crap. She was very reassuring about everything and said she would be referring me back to the hospital if she had any concerns.

Some sensations you have can be deceptive; I remember I thought my fingers were being blocked from bending forward by the metal plate in the last sling I had, but it turned out to be swelling that was the cause. That said, it might be worth seeing your gp for a second opinion just to be reassured if you’re not feeling that from the physio.

Hiya, I broke my wrist (Smith's fracture and ulna styloid) on 4 May this year, so about 7 weeks ago. I was in a fibreglass cast for 17 days after manual manipulation but as it was unsuccessful had surgery day 18. I had an xray 2 weeks later when I was also discharged and referred to PT at the time.

I, too, have been searching for people's experiences for reassurance/what to expect and have been surprised at just how little info is out there; I have had to resort to AI for advice.

I'm still in pain and ROM appears to me to be quite limited - certainly I don't feel anywhere near able to drive and common opinion seems to suggest driving is feasible within 4 - 8 weeks of surgery - but ° ROM has not been measured.

I have my 2nd PT appointment on 10 July (I'm in thd UK) when they hope to commence 'strength' training. I've been off work since the accident and RTW full time on 2 July; I'm worried I'm not going to be ready - with the constant pain I'm struggling to sleep - and am very 'short' with my husband - but I'm also expecting a parathyroidectomy later this year too...

I've been applying an ice pack to my hand/wrist and forearm 2-3 times daily as well as taking paracetamol while doing the exercises at the same time regularly. I seem to hit a 'brick wall' when I try to move my wrist backwards/forwards, which worries me, and I'm not able to turn my palm upwards without some pain. My forearm also hurts periodically too - especially on the ulna side - and with a history of breast cancer (in my mid 30s; I'm in my mid 50s now) I'm really worried about developing lymphoedema.

As you'll probably have picked up, I'm feeling quite despondent and I apologise. However, I am trying also to remain upbeat and am hopeful that time will help ease the pain and that over the next few months things will start to look a little more promising....

Please provide an update of your progress if you're able but if not I wish you a successful recovery over time. 🙏

Hi @Nazla, I’m sorry you’re having a miserable time with your wrist and had to wait so long for surgery - I was lucky as they did mine the next day after not being able to get it into alignment. I've just looked up Smith’s fracture and it seems to be the same as mine, but 'reverse' - did you fall onto the back of your hand?

Absolutely agree that it’s hard to get information and personal experiences. 7 weeks doesn’t sound very long to me, so I’m not surprised you’re still in pain. I was definitely finding it pretty hard to turn my hand palm upwards at that point, and was in quite a bit of discomfort daily. I was also taking paracetamol at 4-hour intervals all day. I didn't have great ROM either at that point, but just kept plugging away at trying to do my exercises. I was advised to try warmth on the wrist - not great in this heat, I know, but maybe once it’s a bit cooler, you could give that a go? I had a pack I warmed up in the microwave and put that on for 5 minutes before doing my exercises.

I'm roughly 5 months down the line now, and feeling much, much better. There came a point where it all seemed to improve quite suddenly. I'm using my hand more or less normally and while it’s not back to 100% full function (fingers still a tiny bit swollen and wrist can occasionally be stiff and achy) I now feel confident it'll get there.

I had pain on the ulnar side, and up the forearm too. It still comes and goes a bit, but it’s becoming a passing thing. Basically I think recovery has been much harder and more miserable than I anticipated, but the body does quietly do its stuff of healing, and if you can hang on to the idea that you’re still quite early on in the process, perhaps that can give you some reassurance?

My physio reassured me that it would take time - up to a year to regain 100% normality - and that if you just keep doing the exercises you'll gradually get there. Hope this makes it all feel a bit less daunting. Best of luck to you.

(PS my DH had to put up with me being very snappy too…..🥴)

I had a colles fracture and plate about 15 years ago.

My forearm arm and grip is slightly weaker than the other side. Range of movement is slightly less than normal in some directions. Bit no lasting pain and it works fine.

@Vinculum thank you so much for replying, and so quickly. Clearly I've lost all sense of time as when I read your post I thought you were only 2 weeks ahead of me in the recovery process. Time has truly stood still for me since I had the accident.

I'm so pleased to hear you're feeling much, much better even if you have some room for improvement still. I've been worried about the ongoing need for painkillers but it's good to know that it's not unusual to clock-watch until the next dose of paracetamol. And thank you too for the reassurance; that so long as I do the exercises I just need to trust my body to heal over time.

As for the fall itself - it being a Smith's fracture rather than Colles - quite honestly I really don't understand as it all happened so quickly. Other than not going for a run that day I'm not sure what else I could have done to have avoided the fracture-I can see going forwards that it's going to take time to rebuild my confidence to even just go for a walk on uneven surfaces.im hoping instead to restart exercise through swimming in time.

Thank you agsin for replying. Onwards and upwards 🙂

@Redflagsabounded, that's reassuring to know that you have no lasting pain 15 years later and that even though there's some restriction that your hand, wrist and forearm functional. Thank you! 🙏

@nazia it took a long time for me to recover as I had some complications. With regards to regaining function - I found the physiotherapy not helpful, but the occupational therapy team at the hospital absolutely amazing! I went 3 times a week and they were fantastic at both the physical rehab and the 'whole person' emotional support. Maybe ask if you can see them as well as physio?

I’m still recovering almost a year after my break and op. As per my earlier post, the physio was encouraging that things were moving in the right direction but slowly.It’s been frustrating but at least I feel I’m coming out the other side at last. I’m never not aware of it as my hand/wrist/fingers are still stiff and quite painful from time to time, and I still have the weird tingling over the surface of the skin when I touch it.

I still don’t have full ROM but am perservering with the physio’s exercises as they do seem to have helped. Sometimes I leave it for a day or so and it actually feels a bit better then; I suppose you’re meant to have rest days from exercise in order for the muscles to grow, so maybe that applies here too.

Strength is slowly coming back (it’s all slow!) and I’m quite impatient for that as I have osteoporosis and really want to work on my strength but am limited to bicep curls of 4kg. Hey ho.
The whole thing’s been quite a trial and I’ve also been shocked at the glacial rate of recovery and the level of pain. I know many people have much worse experiences so try to keep it in perspective - not always easy!
edited for spelling

Ugh, complications are never good...I sensed from my 1st PT appointment some disappointment that I didn't have as much ROM as expected but when I asked what she might expect to see when I returned for my next appointment 10 days later she was non-committal, i.e. 'let's just see'. I know these things take time and will never be the same but I'm just worried that I'll be discharged from PT after 'x' number of sessions and just left to get on with it. I'm conscious too, tho, of limited resources so don't want to demand more if my progress is normal for me and my circumstances. Did the PT refer you to OT or did you ask?

Oh, gosh, yes, that 'weird tingling' sensation on touching the skin-it is painful in its own way imo. And still after almost a year-I feel for you.

Albeit I'm still very early days in comparison, but I too am very conscious of my hand/fingers-I had a mastectomy and immediate reconstruction on the same side 18 years ago and have, therefore, always been aware of the different feeling opposed to my other side but, until recently, I now realise, had become accustomed to it; this fracture has just reminded me of just how odd one side of my body is to the other-I just hope it won't take another 18 years for me to not notice the difference again 🙂

I'd be interested to know if you're following a strength training plan at all? I too have osteoporosis and am just overwhelmed by what to do/not to do/eat/not eat. It doesn't help that I've also been told that I have primary hyperparathyroidism (calcium too high) which alongside BC treatment can also be a contributing cause oc bone loss! It is all a minefield.

Thank you so much for replying/sharing your progress, slow yet steady it has been.

That's a lot for you to cope with, @Nazla. I had a frozen shoulder on the same arm previously so that side isn’t great for me, and is still apt to be painful occasionally. Another reason why the wrist fracture was definitely not great! Sending you healing vibes (and to @Agoddessonamountaintop).

Thanks @Vinculum, it is healing, just slowly.
@Nazla, oh you have had a lot to deal with! The tingling is much better than it was, just lingering tediously.
I don’t know if I’d call it a programme of strength training; I manage about four half hour sessions a week of a video series called melioguide, by a Canadian physio who specialises in osteoporosis. I came across it through a search on here. It’s much easier in a way than any other exercise I’ve done but it’s a matter of having to start at a relatively basic level since to start with I could barely hold a 1kg weight. She explains things really well and I am getting stronger. I should be doing more jumping about-type exercise as well - it’s on my list.
It is quite an overwhelming diagnosis; there’s so much information out there, much of it conflicting, and I’ve arrived at doing what I can and trying to forget about it. I also take alendronic acid - again, lots of conflicting information about that but I decided to take it in the end.

Yes it's crazy, trying to agree what to do for the best isn't it? There's so much contradictory evidence/opinion. I remember being shocked years ago when I'd learnt that tamoxifen can be used for fertility treatment as well as to suppress oestrogen for breast cancer treatment. As for alendronic acid (ive had several infusions of zolendronic acid as well as taken alendronic acid weekly) and you're right, opinion is certainly divided; like you, I've opted to continue to take it while it's offered to me.

Thank you to you all for replying; its not the best situation for any if us but it does help to be able to vocalise things, especially when to my family and friends it feels like all I'm talking about-my wrist and recovery! 🙂

Sympathies again, @Nazla. My mum had osteoporosis (discovered only some considerable time after the family GP had breezily told her that her back pain was 'lumbago' from too much gardening (in fact probably tiny fractures 😞) - and later again she was prescribed alendronic acid….then at some subsequent point told to stop taking it completely, despite never being offered a DEXA scan. But there was less awareness then I think.

@Vinculum ah your poor mum; these throwaway comments can be so damaging. I do wonder tho sometimes whether we are too 'aware' sometimes (every fibre of my body resists that observation but we can get ourselves tied in knots, I think, in thinking 🤔 😀). I'm seeing the PT 2moro; 30 minutes just doesn't seem long enough) but hopefully she'll have seen some progress and will book me in for another session. Its been good to talk to you all. Thank you. n