/ Distsal Radius Fracture advice

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bubblewrap - on 23 Nov 2012
Hi,

I fractured my wrist last weekend and was told today that i probably need a plate in it but its borderline,the other option is setting it in a cast for 6 weeks. Its a Colles/ distal radius fracture. Does anyone on here have any experience of either treatment method or any advice on what to do from a climbers perspective?

Thanks in advance

Will
JDal - on 23 Nov 2012
In reply to bubblewrap:

Presumably it'll be wired if not a plate. My wife had a lower distal radius fracture and had it pinned with wires. It was in a cast for several weeks and then she got a potentially serious infection as the wires naturally came loose whilst hidden under the cast. With hindsight she'd have preferred the plate. A friend had no wires or plate and now has limited wrist movement.

bubblewrap - on 23 Nov 2012
In reply to JDal:

Cheers for the reply, hearing about limited movement without any surgery sells the plate idea nicely (as does infection)

Has anyone else had similar experiences?

Will
JDal - on 24 Nov 2012
In reply to bubblewrap: My wife was asked if she would take part in a study where they are trying to evaluate which is better - stainless wires or titanium plates, she was allocated wires at random. The specialists really don't agree on which is better.


Off the top of my head the pros and cons were:

Wires Pro - Less invasive to fit, cheaper, removed without an operation, not permanent
Anti - Not as strong, needs a cast, they loosen naturally after a few weeks, but it's under the cast so you can't tell and infections are fairly common.
Plate Pro - No cast, strong
Anti - permanent, needs invasive surgery to fit, expensive.

ps that's the exact fracture she had.
GeoffRadcliffe - on 24 Nov 2012
In reply to bubblewrap: Sorry to hear of your plight. One advantage of the plate over a cast is that you can begin to use your wrist a lot sooner and so need a lot less physio. However, ther are also downsides.

I suffered a Colles fracture (distal radius) of my right wrist 14 weeks ago. I was in a cast for 6 weeks. After being in a cast, I lost most of the movement in my wrist and most of my strength. The physio measured my grip strength and it was 1/5 of the strength of my other hand. I have been doing physio for 8 weeks and I have now got a lot of the movement back and my grip strength is now at 50%. I am still unable to climb. An attempt to pull on some holds resulted in a 'pulled' intercostal muscle (needing 6 weeks to repair). This was probably due to the weakness in my wrist causing muscles from other areas to be recruited. I am seeing a physio and an occupational therapist regularly but it's a long haul. I use a compression glove to try and reduce the swelling in my hand and fingers. I am hoping to get back to doing easy routes within 6 months of the break however I need to do loads of specific exercises every day using therapeutic putty and light weights.

Good luck!
bubblewrap - on 25 Nov 2012
In reply to GeoffRadcliffe:

Geoff, was yours just put in a cast with no surgery? It sounds hard work getting going again, if the the op reduces the time away from normal use i guess it could really help me. Have they given any specific reason for your grip strength reducing so much? 80%is alot to have to recover.

Hope you manage a full recovery,

Will
James Jackson on 25 Nov 2012
In reply to bubblewrap:

I had a lower distal radius fracture when I was 17. Sounds like yours is rather more serious than mine, as I didn't require any surgery, just a cast. Even so, the wrist was not as strong for a good few years after - screwed up my ability to play 'cello.
ross - on 25 Nov 2012
In reply to bubblewrap: Hi Will, my girlfriend had radius and ulna wired a couple of months ago. The wires were just pulled out once the cast was removed. She got full movement back very quickly and her strength is improving fast.
Hope you get a good result, Ross.
sleavesley on 25 Nov 2012
In reply to bubblewrap: the orthopaedic consultant/registrar/sho will or should take your job and hobbies into account when looking at treatment options. You could/should speak to them about it.
If its not a bad fracture and it has been reduced successfully there would be no need for surgery.
Where has I take it, your follow up X-ray it has shown that it hasn't reduced enough so may have a problem with malunion.
It isn't a matter of having x or y. It is dependent on how he fracture presents, is it intra articular, comminuted etc etc.
The options are cast, k wire which is less invasive surgery or open reduction and fixation.
Pro's & Cons to them all.
The hospital will often have a meeting to discuss all cases and as a team decide on the best treatment given all clinical details and information about that person.

Good luck with the rehabilitation, most people are their own worst enemy though when it comes to wanting to get back to do something too soon, which ends in longer away from the things you love doing! Listen to the physio and consultants!
GeoffRadcliffe - on 26 Nov 2012
In reply to bubblewrap: No surgery.
Unless you are young (less than 21'ish), the standard time for being in a cast is 6 weeks. The physios and OT think I am progressing well, if not better than expected. None of them have been surprised that my strength has been reduced so much.
Being in a cast for 6 weeks and not using your muscles at all will weaken them considerably. Also your joints will stiffen up. After getting the cast off, my main consideration for the next 6 weeks was getting movement back in my wrist and fingers. It is only relatively recently that I am able to try strengthening exercises.

I am now speniding up to 2 hours a day doing moblity and strength exrecises.

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