UKC

Hi,

Some of you may recall my recent posts about a first family ski trip - thanks to those that replied.

The trip started really well - the kids took to it like ducks to water and the weather was fantastic, so we were having a great time.

Unfortunately, on the 4th day, my wife fell awkwardly on a blue run and badly broke her arm - 3 weeks ago today. To summarise, she had surgery in France and now has plates in her wrist and her elbow. Since returning to the UK, we've seen an orthopaedic surgeon, who seems happy with the work done in France and she's also started physio.

She is, however, very anxious about how much she can move her elbow and loss of sensation in her fingers - especially as it's her dominant arm. The surgical notes say the ulnar nerve was protected and no damage and no "undesirable events" - she can move her fingers and grip, she just can't feel it in much in her ring finger and not at all in her little finger.

Post-surgery, she's obviously been very bruised and swollen from upper arm to fingers. This has gone down a lot, but she still has quite a bit around her elbow and forearm, which is limiting movement of the elbow. Also not helped by the scar being a bit scabby and she's wary of over-stressing that.

She's able to flex her elbow from about 90 degrees to about 135 degrees, but no more at the moment.

I'd be interested to hear of other people's experiences of similar injuries and rehab - but only the positive ones, please.

Thanks in advance,

I bassically destroyed my left elbow last year by landing on an outstretched arm from a 6m fall pushing my ulna out the back of my elbow joint 🤢

This may not be very comparable as I was operated on quickly by a non specialist, due to risk of infection, with little reconstructive work with the expectation I would need further surgery (which luckily I didn't, but it does mean my recovery is a bit different). 

I had very little mobility when the plaster was off, but started private physio almost straight away. I got most of my mobility back after about 3-4 months (sticking strictly to the physio) but have lost about 10 degrees permanently. This isn't actually that big a deal though, allthough it means I can't do a handstand (not that I could before).  

I got on my first climb after 2 months, easy toproping but it was very painfull, I was fully climbing (I.e recovered) at 6 months helped a lot by all the shoulder strength training I was doing as part of the physio. 

My scar is also really not to bad now, if you're active with the arm apparently it stops a lot of the nasty scared tissue developing.

My advice is a) get a good physio that understands your aims and do the exercises! and b) don't be overcautious, the damage has been done, by moving it and building back strength, allthough it will feel awful, will pay dividends in the long term.

Re this point, after abdominal surgery, I used to massage the scar as soon as the surface layer had joined. Did this a 2/3 times a day which helped keep the skin moisturised and flexible, and (may have?) helped healing overall and get the feeling back into the area quicker. 

If the skin is dry, scabby and tight it will be harder to do physio. I would be massaging any significant scar tissue, and I don’t see why that would hinder recovery if the wound is kept clean (unless she has been advised otherwise of course). Start softly. I used bio oil btw (though not specifically recommending that product as such but it did the job well for me - I happened to have it available in the house anyway). 

Yep absolutely echo this point (as soon as the wound is properly heald). also my arm was properly swollen and minging when the paster was off, but looked vaguely normal after 2ish weeks.

Also, when you can get the arm about 25 degrees from normal you should get a plastic splint to sleep in to straighten it out more (which is horrid but seems to work)

Yikes!

Yes - the UK ortho said the same. My Mum is an ex-"pretty much everything in nursing" and was really helpful encouraging her to move it and start massaging everything to shift the bruising/swelling as soon as we got home, before we saw either of the UK ortho/physio.

Yes, the physio seems good. Another point my Mum laboured with her early on - with the plates, you can't do any more damage, so get it moving.

Yes - we're doing that with a cream called "DoubleBase", apparently used by my Mum in clinical setting, so recommended. Also have Bio oil in the cabinet.

Still quite painful to massage in places, though.

One last point - when I was talking about reconstructive surgery and recovery in my first post, I ment - my understanding is is if you have had proper reconstructive work by an elbow specialist you should get the full range if motion back (eventually).

She only had a temp cast overnight until the plates were put in, then just dressings and a sling. She's been told to not bother with the sling any more and let gravity help pull her arm down.

Interesting about the plastic cast, though - not seen that before.

Yes, the hospital in France was a specialist arm injuries clinic. UK ortho had a slight concern that one of the plates they've put in her elbow was slightly long over the end of her elbow which "might" stop her fully extending her arm, but way too early to tell. If it does turn out to be an issue, we could consider having it removed.

It's made of a sheet of plastic they put in a water bath to soften it and then mould to your arm, it can then be re moulded as you regain mobility, simple but clever. 

I'm surprised how little impact the loss of motion is for me, it mainly stops me reaching things off high shelves with that arm, fully resting on jugs on my left and some yoga poses. Things I'm willing to sacrifice to avoid more surgery. 

If you were a champion weightlifter or rower and needed to lock your elbow joint out I can see it would be an issue.

My wife is a keen tennis player, so we'll have to see if that's impacted.

She also enjoys running - I think she'll feel a lot better once she's managed a run, when she's up to it/allowed.