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Arm, Wrist & Hand Message Board


Bone Disorders Board Index


Ulnar shortening
Jan 7, 2012
[COLOR="Indigo"][B]Has anyone out there had a successful ulnar shortening experience? Looking back, would you have the surgery again? Was it worth it?[/B][/COLOR]

Currently, I have a positive ulnar variance. In the last year, I've sprained my wrist 3 times. My orthopedic hand specialist is recommending ulnar shortening to help prevent future injuries and further long term problems. Right now, I have strength and movement in my wrist, but I'm having pain with gripping motions since my sprain 4 1/2 months ago still hasn't fully healed. I'm looking at arthroscopic surgery for that, but the doctor wants to do the shortening during the same surgery. I have to decide whether or not to have the procedure.
Hi booboo,

I had my follow-up with my Orthopedic doctor today. He wants to do the ulnar shortening and see how my wrist pain does after that. He seems to think if I take care of the Ulnar Impaction Symdrome that some of my other problems will heal up. Thankfully, I don't have any tears that showed up on the MRI. There is still a possibility I'll need to have the arthroscopic surgery down the line.

I filled out my paperwork for the surgery. I just need to call and confirm a date for surgery. I have to figure a time where I'll have a least impact for work. My doctor told me pretty much the same. I'll have a splint/cast on for 2 weeks until my follow-up appointment when I'll receive a cast. Then I'll begin wearing a removable splint about 4 weeks after that if all goes well and begin PT with a hand therapist at that time. I agree with you. I want to be asleep when they saw through the bone.
Hi booboo,

I found out today I'm scheduled for surgery on February 10th. I got clarification that I'll have the splint/cast that goes above the elbow until my 2 week follow-up, then the short cast for at least 4 weeks before moving to the removable splints.

Sounds like we will be able to go through this procedure together.

Here's wishing us well! :wave:
Hi,
Yes I've noticed that these forums are filled with horror stories. I had my surgery on 12 Dec 2011 so I'm now 6.5 weeks in. The surgery was on my right arm (I'm right handed).

The surgery itself was not half as scary as it sounds. For the first week I was in a plaster cast - below the elbow (although some surgeons favour the full cast mine saw no reason to use it). The worst part was having to keep the arm raised all the time for the first 5 days - tricky, I hooked the foam support sling onto a floor lamp (top tip from a nurse at the hospital) to give it some support - in the hospital they use a drip stand. The pain was really manageable, just take all the drugs exactly as they tell you - don't wait till it hurts just take them after the right number of hours. The worst part is the constipation the opiate based drugs they give you cause! I took the pain meds for three days then reduced them down, as it didn't hurt during the day I just took some before bed as you need to keep the arm raised at night for at least two weeks which puts a lot of pressure on your shoulder. If you don't have it raised enough then it swells and that's when it hurts....

After a week I was put into a removable thermoplastic splint. Which I still have to wear. I started physio 5.5 weeks in and at the moment we are trying to regain flexibility. Bending is good but pronation and supination (turning palm downwards and upwards) is very difficult - although completely normal at this stage.

I've had a great experience so far. My advice is not to push too hard too soon - I didn't use my hand at all for three weeks then only lightly since then (ie holding down a piece of bread with a flat hand so doesn't move while buttering it) not holding or gripping as that will cause issues with the tendons and ligaments of the wrist/hand which will undoubtedly have been damaged by the abutment of the ulnar onto the carpel bones. I have grade III ligament damage so it's not like it's perfect in there.

I work in an office so came back after the christmas break (three weeks after surgery) and just just use my left hand on the computer but if you need to use your hand at work I'd listen to your physiotherapist for advice.

So far I'd definitely say it was worth it, there have been times that I've been in more pain before surgery than after it.....and now even during physio I'm virtually pain free.

If you want to ask me any questions as you go through stuff let me know.
Thanks for your response JG1000. I've had some really long days this week and this is the first I've had time to really respond.

I'm glad to hear you are doing well. I hope my progress is as successful as yours has been. I appreciate your tips. I'm sure I'll put them to good use.

I'm right handed and having the surgery on that wrist as well. Thankfully, I don't have the same ligament damage. Right now, mine are just really inflammed. I'm hoping this surgery will help keep me from doing permenant damage since I already hurt it 3 times in the last year. I'm 5 months out from my last sprain and it still hasn't fully healed.

I've been on painkillers before so with regards to the constipation, I'm prepared to deal with that.

If you don't mind, I do have a couple questions though. I'll probably have even more later too.

You state you returned to work after 3 weeks. How long did your doctor actually recommend? Mine said I could return to work after I stopped needing the painkillers during the day and that he expected that to be about a week. Right now, I'm scheduled to return to light duty work after 11 days. Does that sound unreasonable? I'm in a department of 4 and unfortunately another co-worker is also out for surgery at the same time so I'd rather not take off for too long.

Also, what about driving? My orthopedic doctor said I could drive with the cast once I'm off the painkillers. Have you found that to be doable?

You mentioned the shoulder pressure, how bad has that been? I had decompression surgery on my right shoulder, same arm as where I'm having surgery this time, a couple years ago. My shoulder is prone to subluxation and the muscles are already frequently tight. I'm concerned about it getting worse. I spoke to my doc they won't do anything for the shoulder until I have problems enough to warrant their help.

I'm scheduled to be in the long arm cast for 10-14 days, then a short arm one for 4 weeks, then a splint.

I'm a bit concerned since I live alone. I have help 24/7 for the first 6 days. After that, I'm on my own. I'm not sure yet how well I'll cope and I'm worried. Any suggestions on things I could do to prepare in advance would be appreciated as well.

Thanks again. Take care.

MountainReader
Thanks BooBoo.

I almost wish I'd be in the hospital overnight. My surgery is in an outpatient surgical center. I'll be home within hours of my surgery. It usually takes me a little longer than usual to come out of the anesthesia and I get extremely nauseaus so the time right after the surgery is usually tough for me.

I'll keep you posted before you have your surgery.

Thanks for your well wishes. :wave:
Hi BooBoo. I thought I responded last night. Must still be a bit under the influence of my meds. Typing is a bit difficult still.

My procedure went well. I went in for my appointment at 7:15 and was out about of the center on my way home about noon. I was pleasantly surprised when I woke up and found I was in a short cast instead of a long one.

I had a bunch of issues with nausea for the first day, but I have nausea issues with anesthesia on a whole.

I went home with prescriptions for percocet, a muscle relaxer, anti-nausea meds (which I need because of the percocet) and a stool softener. I stayed on the max dose of percocet for the first 4-5 days, and have tapered off on them. Today, I mixed in tylenol as well. Combined with constant icing, I've done well coping. The worst part of things was the constipation. I usually don't have problems, but the meds made things bad and the prescription didn't work. I called my GI doc and he just had me double up on dosages of Miralax which eventually did their job.

I'm happy to say that my splint is now a bit big around the hand because the swelling has significantly decreased. I'm looking forward to getting my other cast next Tuesday.

I did end up with an ugly bruise where they put my IV in on my left hand and a huge bruise on my upper right arm where they put the tournequette during surgery.

Overall, the experience has gone well so far (with the exception of one accidental bump :eek:). (Did I say ice was my friend? I loved my kitchen Ninja because it crushed the ice to snowcone fine which molded great in the ice pack.)

I'm looking forward to comparing notes.

Good luck with your procedure.
Booboo,

Thanks for your update. I'm glad all went well.

I had 4 mm removed. I went from the 1/2 cast/splint to the regular cast at 2 weeks. Maybe a bit sooner than you. They did an x-ray at that time to make sure everything was still lined up well. I go back in about another 3-4 weeks to get the cast off and go into a splint.. if all goes well.

Something I found interesting is that they have you in a sling. They didn't put me in one. They did tell me to keep my arm up at about a 90 degree angle with my hand up for the first several days so the blood went down and I kept it propped up for about a week almost non-stop though. I wonder why the difference...? I'm still propping my arm on the pillows when I get home from work and while I sleep. I'm also still icing it down as much as possible. I had ice on it about 50% of the time post-surgery

I stayed on my pain meds 24/7 for the first 1 1/2 weeks. I just went from taking 2 every 4 hours down to taking 1 every 6 hours.

The moderate pain will continue for a bit. A word of warning, when you start using the arm a bit, by the end of the day the pain will return. I wish I'd taken an additional week of leave, even though I haven't been overdoing use of my hand. I'm still taking the prescription pain meds and muscle relaxers when I get home at night. The tylenol isn't enough for a full day yet. It is slowly getting better, but I think it will be a while still. I'm also totally warn out part way through the afternoon. I've had some issues with my shoulder as well. It was already a bit tight, but trying to do anything (like typing) with the cast on throws my shoulder off.

I found a great website and ordered some castshields for showering that have worked well. I also ordered a castcooler which hooks up to a vacuum and helps air circulate under the cast. Seems to be working well so far. I also ordered a couple fun cast covers as well. They look good and also keep my from snagging the cast on my sweaters and fleece.

Stay in touch. I'll update when I have something new as well.
Hi Booboo,

How are you doing this week? Are you adjusting to the cast? How is your pain level now?

I'm doing better in this new splint/cast. It is a lot hotter which I don't like, but I have less pain. I've developed a nice case of bicep tendonitis though. :( I have a shoulder that has a bit of multidirectional instability that I had some problems with back in 2008 which lead to my first ever surgery. I got things back under control for a long time. My shoulder isn't liking that I can't supinate my hand causing me to lift my shoulder/arm at odd angles to do things. Not much I can do for it since I can't take the muscle relaxers while working and I can't do PT on it until I can do my wrist PT. I'll be so so happy when the healing has progressed further. I'm sure you will be too.

I go back in 9 days to get my next set of x-rays and see if I can begin PT. I'm counting down. ;)

Hope you are doing well and showing off that pink cast.

MountainReader
I hurt a lot for a while putting my arm above my head too. I had some horrible stabs of pain when I accidently put my arm over my head while sleeping. What a way to wake up!!!!! That is getting better.

I used a cast shield when showering. It stayed air tight so I didn't have to put my arm up when bathing.

I had orange stuff on my arm from surgery up until I had my steri-strips removed on Thursday. I was happy to finally be able to wash it off.

Vaseline is always a good thing. In the past, I've used it and put cotton gloves over it when sleeping to help with the eczema.
I started therapy today. The OT seems to think I should be back to a normal range of motion within about 4 weeks. Good news if I can get there. :) I was anticipating it would take much longer based on the discussions I had with my doctor prior to surgery.
Sorry to hear about your foot. That is rough.

I couldn't stand not showering that long. I understand the bath thing. I started showering about 1 1/2 weeks after surgery. I found this awesome cast shield for showering. It works a lot like a condom as it goes on. It is a thick latex that I rolled over the cast and up my arm. The ring of latex at the top kept it snug against my bicep. Not a drop of water on my cast and I was able to use the hand a bit through the latex to help as I bathed. Wish I'd realized you were going through that sooner. I would have shared that info sooner.

Stay in touch and good luck.

MountainReader
I had appointments with both my orthopaedic doctor and OT today.

My ortho said my bone is now completely healed and released me to do what I want. I told him I was still having the same pain in my TFCC area as before my surgery when I grip and twist. He said the bone has healed and my MR arthrogram didn't show any tears so I was fine. I asked about what to do if the pain continued and he said come back in 6 weeks, but that there was nothing more he could do. :(

I was very happy to hear my bone has healed well. :) I'm very frustrated and worried about my ulnar sided pain. It has been over a year now and I don't seem to be any better there and my doc is telling me things are fine because he can't see anything wrong.

I think I'll give it a month and if it is still hurting in my TFCC area I may go get a second opinion.

I still have pain with some activities, but the osteotomy ROM is slowly getting better. My OT said to do what I can, but stop if it hurts and not to be overly aggressive in trying new things.
Hi. I figured we'd touch base after your upcoming appointment.

My OT progress has really slowed the last few weeks. I still can't get get my hand into a palms up or palms down position yet. I was very frustrated last friday. My OT called and said my insurance had changed its mind and wouldn't cover any more sessions because I hadn't made enough progress recently. I'm in the process of appealing the insurance, in the meantime, I can't have any therapy and I have to keep plugging along on my own.

I'm also frustrated because I have the same pain in my TFCC area that I had before surgery. I'm now 13 weeks out from surgery and not sure how much longer I should give things a chance to heal before seeking another opinion. My MRI didn't show a tear so my current orthopedic doctor won't do anything more.

Hope you don't mind my venting a bit.

On the plus side, my ROM back and forth is pretty good. I met another person who had the ulnar shortening back in September. She had some complications and is still far from being at the point where I am now. That does make me thankful.

How are you progressing? How is your pain? Are you regaining your ROM like you want?
I've seen my x-rays too. They look good and show the bone is healed.

Unfortunately, I'm very slow in regaining my ROM. I'm maybe 2/3 of the way there towards palms up and palm down. It is frustrating. I keep plugging along using it hoping it will eventually get there.

I'm still having pain in my TFCC area though. My doc said nothing showed on the MRI or Arthrogram so nothing is wrong. It is very frustrating because this is the same pain I had before the surgery.

I'm trying to give it time, but I'm wondering if I will need to go in for more testing with another opinion.
My doc only did the ulnar osteotomy on my and not any arthroscopic surgery. I'm thinking maybe there is a tear in my TFCC area that didn't show up on my MRI.

I bought this thing called a Wrist Widget last week. It is a special type of "splint" designed specifically for ulnar sided pain. I thought I'd try it for a few weeks to see if it helps. It gives me ulnar wrist support without impeding my wrist movement. It is fairly comfortable. I'll let you know how it goes.
Hi there, Am looking at thte same surgery. How did yours go for you?
[QUOTE=booboo31;4907441]Hi I'm new here. I'm having arthroscopy and ulnar osteotomy in the same op. I've had my pre op assesment so just waiting for the date now. I found out that I'll have a temp cast on til i go home the following day, then have a back slab for 2 weeks then have a fibre cast on for 4/6 weeks then start physio.

I was given a couple of leaflets about anesthetic and blood clots. I'll also have to have an injection in my tummy to thin my blood but I'm not worried about that. A friend of mine said instead of having a gen anesthetic to have a nerve block and be awake when its done but I'm not sure. I'd rather be asleep then here wats goin on.[/QUOTE]
booboo, how are you doing after your surgery? Can you give me an update. My dr wants to do the shortening procedure on my right arm and I am very reluctant. thank you!!!
Hi. Welcome to HealthBoards.

My bone has actually healed up well from the procedure. I'm still having some problems though, but they are related to my original injury. I had the Ulnar Osteotomy without any arthroscopic work on my TFCC area. I'm wondering now if I have a bit of a tear in that area that didn't show on my MRI. I'm still working on regaining my full ROM, but I'm able to do most activities outside of heavy lifting now.

The first 10 days, I just did the sponge bath thing and washed my hair in the sink. I bought some baby wipes to help me feel fresher as well. I had some help at first, but figured a routine I could use after that. For showering, I found a great product called a Cast Shield that I used once I got my fiberglass cast on. It pretty much worked like a large condom. I was able to roll it up over the cast and it stayed secure on my upper arm without any fastening at all. I never had any water get in. I was able to figure a way to use the ends of my fingers through the cast cover while I showered so that bit of an assist made things a bit easier.

I was worried about the hair thing. I have fairly short hair. I had a haircut scheduled about a week after surgery and I told my hairstylist I needed something I could do one-handed. He really texturized my hair out and cut it a bit shorter. He then dried my hair left-handed to make sure I could do it that way. For the hair gel, he showed me how to squeeze a bit out onto my counter so I could spread it well over my good hand for styling. I then just used a wipe to clean the counter.

For dressing, I used large t-shirts directly after surgery. I found a good front-hook bra that worked well for me when I went back to work. Doing my pants up was a bit of a problem. I was fairly limited in my work pants since most had buttons that were hard to do. At home, sweats and yoga pants were my choice. I think summer clothing would probably be easier than finding stuff in the middle of the winter. None of my winter coats had a sleeve big enough to go over the cast. I wore vests, but it can get quite cold here and I froze part of the time just doing general running around for work and errands.

What kind of symptoms or injury do you have that warrants your doc recommending the surgery?
[QUOTE=MountainReader;4906604][COLOR="Indigo"][B]Has anyone out there had a successful ulnar shortening experience? Looking back, would you have the surgery again? Was it worth it?[/B][/COLOR]

Currently, I have a positive ulnar variance. In the last year, I've sprained my wrist 3 times. My orthopedic hand specialist is recommending ulnar shortening to help prevent future injuries and further long term problems. Right now, I have strength and movement in my wrist, but I'm having pain with gripping motions since my sprain 4 1/2 months ago still hasn't fully healed. I'm looking at arthroscopic surgery for that, but the doctor wants to do the shortening during the same surgery. I have to decide whether or not to have the procedure.[/QUOTE]

Hello,I had this surgery on my right arm 18 years ago,I am glad it lasted so long.I am a Barber and now I have loss alot of use in my hand and arm ,the pins are coming out due to an auto accident and I'm having a problem finding a Dr.to fix this issue.Think about the long term effects and your age before doing so,the procedure healed well and I may not of had any problems.I am guessing that the auto accident is what has caused my problems.My arm was fine until the accident.
Hi MGBarber43,

Welcome to HealthBoards. I'm sorry to hear about your struggles and your accident. I'm in the process of looking for someone for a 3rd opinion. My Ulnar Osteotomy appears to be successful, but it didn't actually solve my original problem.

You should be able to get the hardware removed if you request it. Your bone should be long healed by now. I asked my orthopedic doc about it before surgery and he said if I ever needed to it was an option. It sounds like you may have some sort of additional injury as well. I wish you well in finding a good specialist. It is hard to find good hand/wrist specialists.

Take care,
MountainReader
Hi booboo,
Thanks for the update. Sorry to hear you are still having problems. How is your range of motion? Can you pronate and suppinate well yet... I can't. I can get about 2/3 the way there both palm up and palm down.

I'm still having some issues as well. I'm wondering it they shouldn't have done some arthroscopic looking around in my TFCC area. I have the same pain there that I had before surgery. I was hoping that the inflammation there would be down and it would be feeling better by now.

My ortho released me 6 weeks after my cast came off. I've been filing insurance appeals trying to get more PT. I just got my last denial saying that because my pain wasn't improving that PT wasn't medically necessary. Go figure.

When I get a bit more money saved up, I need to get a 3rd opinion from another hand specialist. I still believe there is some sort of TFCC tear, even if it doesn't show on the MRI. This all started while I was bowling about a year and a half ago. I throw a 14lb. ball with a hook and I think did something on a release.

I'll post when I have anything new as well.

Wishing you well,
MountainReader
Hi, I have a LONG history with a right wrist injury (Iím right handed).

Random hit in water polo in 2002 started it I think, then I just ignored the pain and pushed it to its limit. Then in 2004 I finally went to the doctor, was given a removable cast and told to suck it up.

In 2008 I finally had arthroscopy Ė not much damage was found in there. Recovery was easy and everything seemed fine Ė until I started actually using my wrist again and then things got way worse.

At this point I couldnít pick up a milk jug or turn a door handle.

In 2010 I had an ulnar osteotomy. Surgery went according to plan. Recovery was really hard. Lot of physical therapy. But in about 6 months I was better than ever.

Only problem is that I HATE the feeling of the plate. I can feel the screws pulling on the bone whenever I do something like swim or canoe or pick up a kid. So in 2011 I had a surgery to remove the plate. This did not go well. The bone re-broke during surgery, my hardware stayed in, and I gained a screw. So frustrating. Felt like such a set back. No physical therapy but still a lot of pain and a lot of waiting. I wore a bone machine (I donít know the technical name) to stimulate bone growth for 10 hours a day for 6 months. Ew. Yuck. Annoying.

So now we are in 2012 and my bone is healed and I am trying to figure out what to do next. The plate still bothers me. I still canít do all the activities that I would like. However, my wrist doesnít hurt for the first time in YEARS. The doctor says that he will try to take it out again, but the bone will probably have to be broken as the screws are really set in there and one of them is stripped. He would replace the plate with a thicker plate and I would get out the thicker plate 1 year after the first surgery.

So Iím faced with the decision of staying where I am- fairly pain free unless I do something fun Ė at least until I have heavy babies and then I guess Iíll be in pain. Or do I have 2 surgeries that eat up the next 2 years of my life?

Youíve been through this. What do you think?
I'm glad you are getting some help. I've read about the possibility of the bone breaking too. It sounds like there is a pretty low percentage of that happening. I'll pray that that is the case for you.

I go in on the 12th to a new orthopedic doctor. I'd hoped to get more of my medical bills paid off first, but I decided I couldn't wait. I had someone demonstrating a "new" sport to me. It's called Pickleball (you can look it up). Wierd name... It involves hitting a wiffle ball with a wooden paddle a bit bigger than a ping pong paddle. I experimented, wearing a splint, and it really hurt to hit the ball. If I can't swing to hit a small light plastic ball with holes in it, that is bad. I've grown so used to the pain trying to lift and grasp things that it took trying something different to spur me to seek out that 3rd opinion. I'm trying a different approach this time and hoping 3rd time is a charm in getting my answer.

Keep us posted on how your pre-op and surgery go.

Wishing you well,
MountainReader
Hi Booboo,

How was your pre-op? Do you have your op date yet? Keep me posted. I'm keeping positive thoughts for you.

I went to a new surgeon for a consult today. Since my last one said there was nothing more he could do for me, I was pretty discouraged. They just did the ulnar shortening hoping to heal my ulnar side pain and I still have the same pain as pre-surgery. The doctor today gave me hope. At first I was a bit concerned because when he did his initial assessing he wasn't getting to the right spots. He then asked me to show him where my pain is and after that he hit the sweet spots for my pain. He did some more thorough checking and then had a nice discussion with me. There are 3 things he said appear to be of possible concern that are all seperate from the ulnar impaction from before. 1. I have a UT split tear. That doesn't show on an MRI. It can be fixed arthroscopically. 2. the head of my ulnar bone is a bit too pointy and may need to be rounded down a bit. 3. I have another ulnar side problem all together. :confused: He thinks I didn't realize the pain if it because of my ulnar fovea/TFCC area pain. Evidently the bones on the pinky side between the bottom of my finger and wrist are extremely lax and unstable. I may need to have the ligaments tightened. He would do that and put in a pins until it stabalizes when the pins would be removed. Anyway, for now, he gave me 2 cortizone shots and put me back into a brace for 2 weeks. If the shots help, he may give more shots to see if we can get the inflammation down. If not, I can choose arthroscopic surgery where he will take a look at all three things and look at my TFCC area closer as well. A lot to take in, but at least there is hope for finding a solution to my pain.

I'll check back with my update in a couple weeks.
Will you be in a cast or splint after surgery?

For me after surgery, my biggest issue post surgery is extreme nausea. I had surgery on my stomach a couple years ago and it keeps me from vomiting. They load me with anti-nausea meds and I still sit there wretching. I would love to be able to just get up and start moving around to be released pretty quickly after surgery.

I hope all goes well for you. I'll be sending you positive thoughts.
I noticed you posted on the TMJ board. I missed your original posting. Please make sure they know you are having jaw problems so they are more careful if they intubate you. My TMJ specialist said a surgery I had a few years ago may have actually triggered my tmjd problems.
Yeah I will do, haven't seen my dr at the surgery yet as seein him for back pain. But will tell him about it as soon as.
Hi BooBoo. Do you have a date for your surgery yet? Mine will be november 20th. I have to take leave from work for 2 weeks.

I think we will need to start a new thread soon too. This might be a good time for that.
Hi. I'm new to the forum. I'm having surgery Nov. 5 to have my ulna shortened. I love reading all your experiences. I'm not looking forward to this surgery. It is my right hand. How long do you think it will be before I am able to use my hand.
Hi, I was in a plaster Paris cast with bandage for 2 weeks then was put in a short arm cast for 5 weeks.

I didn't have physio after my surgery my surgeon/consultant let me go on my own. I just took it easy when I first had the last cast off. Having a bath was nice as I cud move it more freely under water.

Try and see if you can get a small squash ball and put it in the palm of your hand and squeeze it. Doesn't have to be to hard just enough so you can feeling it working.

After about 3 weeks after coming out of cast I was able to put my arm up straight so that my thumb was looking at me and turn my wrist. The arm will move aswell. I did that sometimes without knowing I was doin it.

You'll proberly go to physio and they'll show you wat to do.

Hope op goes well x
A whole month is such a long time to wait. It is so much easier to just get it over with. I hope the surgery goes well for you though. Let me know when you have a date set.

I go in Monday to see my new Orthopedic surgeon. I've develope a knot at the base of my scar. I don't know if it is scar tissue or something else. I want it checked before I go in for the other surgery on my wrist. My surgery is just 18 days away. I'm looking forward to getting the elusive tear fixed, but NOT to another 6 weeks in a cast. The first 6 weeks were hard enough. By the end I was getting a bit claustrophobic.

Do bandages or splints help you at all right now or are they just for a bit of protection?
Hi Booboo,

I went to see my surgeon again today. I've developed a squishy bump at the end of my osteotomy scar, towards the elbow, that got bigger over the last few weeks. I thought it was probably scar tissue or some kind of adhesions that had formed, but I wanted to check it out before my surgery in a couple weeks. Turns out it is a cyst that has developed because the plate on that end has loosened some and caused irritation. When I have my arthroscopic surgery on my TFCC area, he is also going to remove my plate and the cyst.

In talking to him about the healing afterwards, he said that if it was only plate removal I wouldn't be casted at all, just a splint. If he finds the tear, which he suspects I have, and fixes it then I will need the cast.

Sounds like we really will be healing up together again since we will both be having plate removal.

On the up side, he said the plate has done its job and the bone has healed well which is good. He also "reassured" me that I very well could have needed the ulnar osteotomy that the other surgeon did. Really makes me wonder if I really needed it now though. It really does depend on the education of the individual surgeons doesn't it?
Good news on not needing a cast.

My surgery is on Tuesday, November 20th. It is 2 days before Thanksgiving (a national holiday here). I'm actually scheduled to travel the day after surgery and I'll stay with family for a week or so. The doc is making me take 2 weeks off of work though. The rest of my recovery time will depend on what he ends up doing when he gets a look at my ligaments.

You are right about the deja vou....
Good to hear. You are finally on the final countdown! Isn't it crazy that we look forward to surgery? I really hope that this surgery is your answer.

I ended up having to go in for some pre-op testing as a requirement for the different surgical center I'm going to. My EKG came back with a problem and now I have to see a Cardiologist first. The person from the surgical center told me that they get false readings all the time and that it is often the maching. My Cardiologist appointment isn't until Monday and my surgery is on Tuesday. I really hope they can process things quickly enough that I can still have the surgery.
Yeah let's hope so. Will be thinking about you on tuesday. Hope your surgery does go ahead. Wud be a bummer if there was a set back.

I am lookin forward to my surgery, im not staying in this time ill be out by lunchtime. Ill just be glad to get the metal work out and try and get back to normal. I've had enough of it now. I'm just hopin i don't have a nerve block like i did last time. It hurt when the bloke was doin it and my fingers were numb til the following day.

I might ask the bloke whose doin it to do it when I'm under that way I can't feel it. The side of my arm near my wrist still goes numb sometimes so I hope that stops. I no it's the nerve cos it feels weird but it does my head in.
My surgeon really didn't set limits on what I can do. I know he wants me off work for 2 weeks. I have it in a thick wrap that won't let me bend my wrist. They did say I can take the wrap off after 48 hours so I can shower. I'm supposed to put the wrap back on afterwards though.

I'm taking it easy in the meantime.

I imagine the 6 weeks is so we have a long enough time for the bone to heal back over. No cast or splint though right now so I take that as a good sign already.

I'm still icing a lot and taking some lower dose Percocets.

It is Thanksgiving today. It is hard for me to watch everyone else cooking dinner. I'm looking forward to the feast though. I know I'll get teased about eating left handed again. You would think that after all the other times I've been splints or casts that I'd be much better eating with my non-dominate hand. I'll never be graceful.

I believe my follow-up appointment is before your surgery. I'll certainly let you know how that goes.

Try not to let it get too much in your head. While it is still surgery, it is much less invasive than our osteotomies.

Take care.
My surgeon used the same incision that was used during the first surgery.

I took a peek this afternoon and it has a big piece of tape over it so I'm not sure about a number of stitches. In my osteotomy, the stitches were all under the skin so I'm not sure how many were used then.

The stitches that I can see are on the spots that he made new incisions in for my arthroscopy on my TFCC area.

My first scar was 4 inches long, but it was very tight and straight so the scaring was thin. I'm assuming that it is the same this time. The surgeon I had this time was a plastics doc so I have high expectations of the final look.
Hi Booboo,

I'm doing well. I go in for my follow-up on Monday. I'm more than ready to get my stitches out. I have 4 knots of stitches sticking up from the top of my hand from the arthroscopic stuff. Once some of the swelling went down, I could see that he just cut open about an inch on each end of my 4 inch osteotomy scar. I had a lot of swelling in-between. I'm assuming that he manouvered under the skin to get those middle screws to get the plate off. There is still a bit of swelling, but it is looking better. I am disappointed in those 1 inch incisions though. My first surgeon did all of my stitches under the skin and I had a thin tight line as my 4 inch scar. This surgeon did the stitches across the top and I can tell my scar is going to look worse. I never thought to ask this surgeon about how he was going to stitch things up because he is a Plastic Surgeon. I guess I just assumed he would do the same as what I had the first time.

I still have some tenderness over the bone and don't quite have my ROM back, but I haven't been wearing any bandages since last Monday. I've been able to have pretty good use of my hand. I haven't tried any heavy lifting or anything yet. I'm still careful.

While I've been functioning fairly well, yesterday I had family members point out to me that I seemed to have more energy. I hadn't realized how much surgery had taken out of me. It makes me realize that I did right by taking a couple weeks off of work.

I'll update you with what my Doctor says on Monday. Are you ready for your surgery this week?
Yeah and no. I'm getting scared about the nerve block cos it made me cry last time and not looking forward to coming out off the anesthetic. Last time I kept shaking and had a bad headache.

Other then that I can't wait for it to be over. My hospital rang me on Friday asking if I was still goin and I asked them what I wud have on my arm and the bloke said ill have a large bandage and a sling to keep it elevated.

Also goin to see if I can get an appointment to have my stitches taken out at the same hospital and not my local surgery because I can never get an appointment with anyone. I was told at the drs the other day we can't make any pre book able appointments til after Xmas you have to ring on the day. So if I remember I'm goin to ask on Wednesday and hope they say yes.

I've also got asthma clinic tomoro mornin so that'll be fun. Not. Lol.

Sorry for babbling on.

Hope Monday goes ok. Talk soon x
Hi again Booboo,

I hope your appointment went well. What type of treatment to you get at your asthma clinic? I get monthly shots for allergic asthma. It is really hard to get a Pulmonologist appointment here. I had major problems at the beginning of September and the soonest I could get in was December 19th. Thankfully my primary care doc and ENT helped me get the asthma back under control.

I had my first follow-up appointment with the surgeon today. He took out all of my stitches, which I was really ready to have out. He seemed surprised my pain level wasn't too bad after all the work he did on me. He said he took a ton of inflammation from my wrist. I asked if it was enough to cause my pain and he said absolutely. He also said the plate had been installed on the surface and that it's location could have caused some of my wrist pain as well, in the exact place the shortening was seeking to heal. He thinks that between the two procedures he anticipates my wrist pain will heal well.

When he drew a picture of the ulnar osteotomy and positioning of the plating, he referred to the nerves that are in that part of the wrist and how the positioning of the plate could cause irritation there. I was thinking of you when he said that. It sounds a lot like the problems you have been having.

He left therapy up to me. I asked him for a referral for therapy. I never gained full ROM after the first surgery and had issues with insurance covering my therapy long enough for my full recovery. The surgeon was pleased with the ROM I already have, but was very supportive of therapy to get me back to normal. He said the initial shortening could have caused a permenant issue with my getting my full palms-up ROM back though.

I go back for another follow-up in 6 weeks.

There are so many different approaches by different doctors. I find it interesting they do the sling. I didn't have one for either procedure. They wanted me to elevate my wrist a lot higher than the sling allows. I spent a lot of time with my wrist propped up on several pillows while I was sitting. I actually propped my elbow and kept my hand up about the height of my ear. The objective is just to help keep the swelling down. I was able to remove my bandage after 48 hours. That was great because it allowed me to shower. I re-wrapped it for about a week just to protect it, but I wasn't required to. It seemed crazy after all of the splints and casts before that I was able to go 'naked' so soon after this surgery.

Keep us posted on how you are doing.

Take care,
MountainReader
Booboo, I'm sending you well wishes and positive thoughts.

I took a shower before my surgery too. I found from the first time that using those baby cleaning wipes was great for cleaning in those early days after surgery. :)

I would love to continue to compare our stories here. Please post when you can.

I start PT tomorrow after work. I'll post you. I'm trying a different Certified Hand Therapist (Occupational Therapist) this time to see how it goes.
[QUOTE=booboo31;5099681]Hi ya, operation went well. I'm in pain the surgeon used the same scar as last time and opened it up. Got to keep bandage on for 2 weeks thats wen the stitches come out . I'm not allowed to get it wet. I've then got to go back in January for my follow up appointment.

I didn't have a nerve block this time, I think thats y I'm in pain. My throat hurts and it's swollen but that won't last long. I do have to wear the sling, my surgeon also said that between now and 3 weeks my arm cud brake so I have to be extra careful.

Hope your doin well and physio goes well x[/QUOTE]

Booboo,
I'm glad to hear things went so well for you.

It is crazy how we can have the same procedure with such different post-op requirements. I had to keep the bandage for 48 hours and you have to keep it for 2 weeks. We both have stitches out at 2 weeks. I had my first ortho follow-up at 2 weeks and yours is over a month. I haven't had to wear a sling. In fact after 48 hours I wasn't required to wear anything on my wrist or arm.

I had my first PT appointment today, 16 days out from surgery. Right now, he wants me to avoid anything with resistance such as lifting, pushing and pulling. He just did an evaluation, 2 extremely light exercises to work on my motion, and some massage. He said massage will really help with the scar and inflammation. He said that if I stick to this routine, I should be near normal with my ROM in a few weeks. I haven't been able to get my palm fully up since my first surgery and he thinks I'll be able to re-gain it. He did emphasize that I can't do anything that causes any pain because it will make the inflammation worse and impede my healing.

I did ask about the 7 holes in my arm and he said that unless I had a fall or hard impact I didn't need to worry about breaking anything. He said they will heal in about the same 6 week timeframe that our bones originally healed. They are weaker in the meantime, but only to hard impacts.

Keep in contact with your progress. I know it isn't fun being all wrapped up and in the sling. You should feel much better after a couple days though. Make sure you keep icing. I iced for about 20 minutes in each hour. It really helps with the swelling and with the pain.

Take care,
MountainReader
Hi Booboo,

How are you doing? Have you been able to wean off of your pain meds yet?

I found propping my arm up on pillows while I slept helped me keep it elevated and kept me from bumping it while I slept.

I hope you are doing using a lot of ice. I know it really helped me a lot with the discomfort.

I'm 19 days post-op. My scars, 6 of them, have almost completely healed over. I just have one spot at the bottom of my ulnar osteotomy that has a scab left. I can tell there is still a small bit of swelling though. My surgeon only cut my osteotomy scar for an inch on either end. He put his tools up under the skin of the space in between to get the plate and screws out. I have a bump and swelling in that in-between space. I figure it will take a lot of massage and PT work to get that part back into order. Without a cast, splint or wrap, it is hard at times to remember not to use my hand for most things. At a glance, it looks just fine. I have some general soreness, but overall the pain is much less than the after the first surgery.

I've had something strange happening though. I've been doing some typing with my hand and I keep having wierd things come out at times. I guess my hand isn't quite able to keep up with how fast my brain wants it to type. Some of my words appear dyslexic at times. I've had to do a lot of proof reading of what I type to make sure it makes sense.
Sorry to hear you are still having problems.

I had bruising on both surgeries. The first one was huge. They put a tourniquet on my arm during both surgeries to reduce the blood flow while they were operating. They really turned wierd colors while healing.

There is a nerve running right through the area where we had our surgeries. I know both my doctors talked to me about it and the risks of damage. They also both told me how they were planning to avoid it. Evidently it is a pretty complicated area to operate on. I'm wondering if you may have had some damage or irritation to that nerve during your first surgery. Did your surgeons talk to you about it?

It might be wise to have another dr. visit to ask about your new symptoms. It sounds like something is really going on. Migraines cam be tough to deal with as well.

I've had 3 PT sessions now. I started a few light exercises last time. He does a lot of scar massage and stretching of my hand and wrist. I have a lot of aching still. I haven't tried doing a lot of lifting yet since I'm still on restrictions from anything with resistance (lifting, pushing, pulling) for a couple more weeks. I need to regain some more ROM and be able to lift before I can tell if my original issue causing pain is healed or not. I will say that my PT seems surprised I have the ROM that I do already. Because of that, he continuously reminds me not to overdo things.

It is hard not wearing a cast or splint. They reminded me constantly not to do something. Without them, I'm constantly having to catch myself from doing something stupid because it so automatic to do something with my dominate hand.
I had a PT appointment again today, my 5th so far this month. My ROM is significantly improved. It really gives me hope I'll be able to fully pronate and supinate again. I wasn't able to do that fully after the last surgery.

I was asking the PT about if he thought I'd be able to go bowling by summer. I had go give up my league bowling for the last season and a half because of all this wrist stuff. I bowl with a 14 lb. ball so I know that will really show my progress when I can get there. The PT actually thinks I may be ready by the end of January. I'm not holding out for that and don't want to push things, but just the possibility of healing up that well in the near future gets me excited. My last surgeon told me that I'd be able to bowl within 4 months and I never even got close. With my current progress since this last surgery, I really believe I'll get there. Tomorrow is my 1 month anniversary since the arthroscopic surgery and plate removal. That is a lot of healing pretty quickly. :)

PT today: I'm doing 2 lb. wrist curls and some light resistance. I also had lots of massage, passive ROM work and some electronic nerve and muscle stimulation.
Hi ya, Happy New Year to you aswell.

I'm not doin to bad. My next appointment is in 2 weeks. I had a bad day with my arm yesterday where I had the same pain as I did after my 1st surgery, I had to ring my dad and ask him what i shud do and he said get a tuba grip and put it on the radiator to warm it up and put it on my arm. He thinks I might have got it cold some how.

At the moment it's ok.

I've been doin alsorts with my arm apart from driving. The numbness in my hand and fingers has near enough stopped which is a good thing.

Glad your doin so well
Hi Booboo,

If I figure right, you are having your surgical follow up this week. I hope it goes well for you.

I had a follow-up with my ortho surgeon today. He seemed extremly happy with my progress. My ROM is now "normal". It isn't normal for me because my wrists are hypermobile, but he doesn't actually want me pushing things that far. He feels my ROM is in a good place. My supination and pronation still have a ways to go though. I will celebrate when I can do a palms-up with my elbow to my side.

I have a couple hard knots along my incision. My surgeon said they appear to be from where I had some internal stitches. He advised to continue to massage the area regularly to break it up. I spoke to him about the pain I feel when I move my hand to the ulnar side. He explained that when I move my wrist in that direction I'm "squishing" the area that is still healing. He said that as long as the scar is still pink on the outside, it is still healing on the inside too. I've never had anyone explain it to me that way before. I guess it is a reminder that I need to be patient through the healing process.

I haven't yet gotten to the movements that were causing me the most pain pre-surgery so I don't know if things have been "fixed" or not. I know it will come with time.

I will say I was excited at PT a couple weeks ago. In one week, my strength reading went from 25 to 50. I know I can't hold that long-term yet, but it was major progress. The doctor said he anticipates I may only need a few more weeks of PT.

When I left, the doctor said that if I continue to have any of the problems I listed above in 6 weeks, that I should come back to see him then. If I'm feeling better with no problems at that time, it isn't necessary for me to return. Here's hoping I heal a lot between now and then.

I wish you luck at your appointment.
Hi booboo,

I have faith you are ready to drive. Just take your time until you are confident. I was driving since 2 weeks after surgery. You should be healed well enough that you shouldn't do much damage. Glad your wrist is starting to feel better. The scar does take time healing. I'm glad yours is looking better. How is your nerve pain doing? Has this surgery helped with that?

Some of the cracking you feel may be normal. I have some with certain PT exercises. My PT observed and felt my wrist when it was cracking and said it was tendons sliding over each other and not to worry about it.

I went to my PT today. He said it was up to me if I wanted to come back or not. He said I was ready to be released if I want. We decided I'd see how I'm doing in a couple weeks. My ROM is actually ahead of where he said is typical. I still have some work to do, but he said it will come. 3 weeks ago, my strength was at 25. 2 weeks ago, it was at 50. Today, I hit 73. My left is at 90 which he said would be my "normal". He said I'm gaining strength faster than usual after a broken bone. He said 6 months to 1 year is normal for full healing. I do have some pain with certain movements or when I do something I'm not ready for, but the pain isn't as intense as it was a couple weeks ago. I'm also healing up from the arthroscopic stuff too. It is easy to get impatient, but I've been going through the wrist pain for almost 23 months so far. It makes it easy to get very excited with some of these milestone steps. I know I'm nearing a "normal" again. I can feel it. I just need to keep working towards it and being patient.

Let me know how your driving goes. I'm rooting for you.
MountainReader
I have had two ulnar shortening surgeries -- Oct 2012 on my left arm, and the other Feb. 26 2013. (I'm wearing a removable brace which I take off to shower). I also had right bone graft surgery in my lunate for Kienbock's Disease in my right wrist, Dec. 2011. Needless to say, I've had my share of it all.

I couldn't tolerate the hydro- or the oxy-condone so the first three days were pretty horrible. My second shortening bruised quite a bit but I was fine with both arms after 4-5 days. My left arm bone healed fine within a month. I'm thin so the plate bothers me but not like the wrist pain. It's tolerable. Of course, I'm still healing from my second surgery.

Tips:
1) Stetch your fingers with the fingers of the opposite hand often before getting the stitches out.
2) I bought Lucy pants prior to my surgery -- easy on, easy off -- and great fit. Just works for women though.
3) For sure, keep your arm up at least five days. I used several pillows to achieve this -- not a big deal. Just keep above your heart. I also used a knee pillow with contours to use as an arm rest on top of the pillows. This REALLY helped.
4) My doctor also gave me compression leggings to wear the first 24 hours. Great idea because they kept my feet warm and my legs safe from blood clots. Some doctors do not offer this before surgery, but I highly recommend it!
5) For showering, I used my New York Times plastic bags to cover my arm and tightened the end with piece of Velcro which would really well.
6) If you have long hair like I do...let it go the first week.
7) Download some good books to your Kindle before the surgery. This is a lifesaver for having to stay in bed.
8) Don't forget to take your B/P med the morning of the surgery, if you have high B/P.
9) MORE IMPORTANTLY, make sure your doctor is a specialized surgery with a lot of experience with these surgeries. Too long or too short is not a good thing!
10) Maintain a really positive attitude! Go with the days as rest days and know it will be better soon.

Good luck!
Sherie
Hi all,

So I got a mri in january and it came back positive for tfcc tear. Was casted for six weeks. Now my pinky has been numb for a few weeks now, kinda consuring. Once the cast came off the pain came back, so they made a custom thumb spica brace to wear which is not comfortable what so ever. So im almost ready to say the cast was more comfortable. Sounds like I need surgery??? the dr also recommend surgery. He also said ill need ulnar shortneing, which I think is causing the pain, whats yall opinon?
I'd say probably yes to surgery if you still have tfcc type pain that hasn't improved with treatment.

I'm unsure about the impact of the thumb spica brace. Do you have pain on that side as well?
So, 2 weeks ago I went in for another surgical follow-up. I still have a bit of ulnar side pain when I move my hand to that direction. He did an exam of the area and said it looked like some tendon inflammation. He gave me a cortisone shot to help try to resolve the inflammation. This is the 4th cortisone shot in my wrist in the last 2 years.

This shot felt different than the rest. They always hurt, but this hurt ALOT. Usually it takes a couple days of pain, then it gets better all around. This time, the pain got worse and spread across the top of my hand and a bit down my wrist. It has also been extremely tender to the touch. I've been on anti-biotics for a week, but it still really hurts. I've been using heat, ice and a wrist splint for the last couple weeks. I really have wondered if he hit something different with this shot. It almost hurts as much as my last surgery.
[QUOTE=sheriej;5144443]I have had two ulnar shortening surgeries -- Oct 2012 on my left arm, and the other Feb. 26 2013. (I'm wearing a removable brace which I take off to shower). I also had right bone graft surgery in my lunate for Kienbock's Disease in my right wrist, Dec. 2011. Needless to say, I've had my share of it all.

I couldn't tolerate the hydro- or the oxy-condone so the first three days were pretty horrible. My second shortening bruised quite a bit but I was fine with both arms after 4-5 days. My left arm bone healed fine within a month. I'm thin so the plate bothers me but not like the wrist pain. It's tolerable. Of course, I'm still healing from my second surgery.

Tips:
1) Stetch your fingers with the fingers of the opposite hand often before getting the stitches out.
2) I bought Lucy pants prior to my surgery -- easy on, easy off -- and great fit. Just works for women though.
3) For sure, keep your arm up at least five days. I used several pillows to achieve this -- not a big deal. Just keep above your heart. I also used a knee pillow with contours to use as an arm rest on top of the pillows. This REALLY helped.
4) My doctor also gave me compression leggings to wear the first 24 hours. Great idea because they kept my feet warm and my legs safe from blood clots. Some doctors do not offer this before surgery, but I highly recommend it!
5) For showering, I used my New York Times plastic bags to cover my arm and tightened the end with piece of Velcro which would really well.
6) If you have long hair like I do...let it go the first week.
7) Download some good books to your Kindle before the surgery. This is a lifesaver for having to stay in bed.
8) Don't forget to take your B/P med the morning of the surgery, if you have high B/P.
9) MORE IMPORTANTLY, make sure your doctor is a specialized surgery with a lot of experience with these surgeries. Too long or too short is not a good thing!
10) Maintain a really positive attitude! Go with the days as rest days and know it will be better soon.

Good luck!
Sherie[/QUOTE]

Thanks Sherie,
for the good tips, I have just had Carpal tunnel release on my right wrist and in a few weeks going to have Ulna Shortening done on the same wrist then of course both done again on my left wrist once the right side has healed. Very worried about the outcome having both arms done.
I have been off work now for three months and have been told I will never return to my type of work as the repetitive work load has coursed to much damage. So hard to keep positive but know I have to, just want to be healed and back working and riding my bike :].
Thanks again :]
[QUOTE=marlin33;5152721]oh geez that doesnt sound good. Thats the brace the dr gave me. I thought bout trying the exos brace or possibly just a cast, but cant have it forever. Im guessing dr have to follow certain procedures.? I really want to avoid the shot, since it screwed up my ankle.[/QUOTE]

After surgery I had a fiberglass cast. I had a few problems with my second one. (For some reason I developed tendonitis in my thumb while I had it on.) The orthopedic surgeon then gave me an exos brace/cast. They are pretty great. Quite comfortable, molded to the arm, and hard as the cast.

Not sure what is up with the cortisone, but I'm going back to my hand surgeon tomorrow to have it checked out.
Went to the dr yesterday, still in pain, he gave me the exos brace and reccomended a wrist anthrogram which I had years ago and was vry painful. Im not sure to do now. He went from saying it was a tear to just a spain, so I had probelms with the tfcc in high school, refused surgery then, and it kinda went away. Confused what to do now, since I was shooting for surgery and am still in lots of pain.
I wore an exos splint/cast for a while. I was impressed by the technology.

I had a wrist arthrogram and MRI (arthrogram provided the contrast material for that too) before I had surgery a year ago. I didn't find the arthrogram to be that bad. I've certainly had worse in terms of testing. It might depend on the skill of the doctor who administers it.

I think the best thing is finding a good orthopedic specialist who is trained in hands and wrists. That has been one of my biggest challenges. I know that the tfcc area is a very difficult area to treat. I've had multiple doctors tell me that. I'd ask lots of questions to your doctor and get another opinion if you feel you need to.

I'm on my 3rd orthopedic specialist. I finally found one who did a fellowship at the Mayo Clinic with a doctor who has done tons of research on treating ulnar pain.

Since you had an untreated issue so many years ago, do you have an area that just didn't heal properly back then? I'd ask about that and if it was fixable. From all of my reading, I know some tears are and others aren't.

You might try doing research on UT Split Tears. It is a tear of the ulnotriquetal (UT) ligament. Instead of splitting across the ligament, it is a tear that opens the ligament like a book. Because the bloodflow is still there, it doesn't show on any tests like the arthrogram or MRI. It is newly discovered and research was only published on it in 2008 and the majority of doctors out there aren't familiar with it. Arthroscopic surgery is the only way to check for it, but you need a surgeon familiar with the injury who knows how to look for it. It can cause pain in the same tfcc area.

My current surgeon was trained on this and thought I might have a tear until I had surgery and he couldn't find anything other than tons of inflammation. I'm still having some pain in that area though and he mentioned the possibility of the tear at my last appointment. Makes me wonder if I have some microtears or something that just isn't bad enough yet to really be evident.

Keep us posted on how you are doing.
Have you been icing your wrist since you hurt it again?

It might be time to get that arthrogram you had recommended. See what shows up.

My guess is that ulnar shortening surgery wouldn't relieve your pain by itself, but it would give you more room and allow for swelling to go down in your tfcc area. If you have a significant tear, it might need surgery.

If you swelled up a lot, do you think you exasperated your injury or gave yourself a new injury with your accident this weekend?
I want to start by thanking you MountainReader and booboo31 I have read all your postings on Ulna shortening and have found interesting and helpful.
8 weeks ago I had Carpal Tunnel release done on my right wrist and my surgeon also decided to have a look around at my Ulna head etc as my MRI showed signs of Ulna impaction. On the 24th April I under went ARTHROSCOPIC PROCEDURE to repair Ulna quadrant radio carpal surface of the lunate (pior chondroplasty) and debridement of triangular fibrocartilage and 3mm 45 degrees Ulna shortening.
I spent 2 nights in hospital more due to low blood pressure, I only had a soft forearm bandage on until the day I was discharged and Hand Therapist took my drain out of my arm which I found very painful, then made a short forearm removable splint and had me doing arm exercises straight away. After my 2nd day home I took myself of the pain tablets as they made me feels sick, so have only been using Panadol to manage the pain which has been hard but getting there. After a week from surgery I have started using ice packing to help with burning pain in the arm. I am returning to hand therapy on Friday and to also have three staples removed. I also have an appointment with my specialist on Friday to discuss surgery on my left arm.
BurtG,

I find it interesting how different all of our treatment plans post-surgery are so different. I was told not to do anything with my hand until the cast came off at 6 weeks and you started your therapy immediately. I think the advantage of yours may be helping you with your ROM. My therapists told me that as long as there was ulnar pain with exercises not to push it though because it can perpetuate the inflammation.

Sorry to hear you had the hospital stay. I had both of my procedures in surgical centers and went home immediately after. I hope your BP is doing better.

I purchased a wrist ice wrap off the internet. Since you are dealing with both wrists, it may be something to consider. Mine is rectangular with a slit in it so I could stick my thumb through. It works with my splints, casts and just plain. Ice and elevation are your friend here.

Keep us posted on your progress.
mountainReader,
It is amazing how different specialist work with patients. I have had a good day today being one week from surgery but icing heaps, yes great wrist ice wrap I will search that soon and buy one ;)
It is amazing how much my rom has improved in one week I can feel a lot of pulling like tight elastic pulling, but my specialist said that would feel that. I will be interested to see the measurements on Friday of how well I have done with my rom.
You know when reading your story's and going through it myself it was great as I knew the right questions to ask , and was not left wondering.
I worry about the plate and hope that it does not cause any issue's. How does yours feel ?
My BP has settled down so happy with that ;) when I am resting watching tv I take my splint off and icing feels so much nicer than having the splint on, not really sure if I am meant to do that but will find out Friday. Maybe once I have a wrist wrap I might not need to do that.
Here is a little back ground of my story.
I have been off work now for four months as I can not return until 100 % which has been difficult. When work sent me to their work doctor they decided they would treat my pain for carpal tunnel and did not send me for MRI just a hand therapist who decided that splinting my arms for 8 weeks was the way to correct my hands. When I finally got referred to the specialist he was not happy as the splints had coursed other issues which made it hard to know what he was looking at. Even I could not explain where the pain was coming from then.
You are very right in one of your posts MountainReader having a hand specialist that is good makes a lot of difference. For anyone looking at having Ulna shortening very important you do you back ground checking and get the right person.
I will keep you updated and will look forward to your updates.
;)
Well today I had surgeon to sort out my MRI for left arm so that is now under way of getting sorted. I also got to watch my surgery on DVD fantastic amazing how technology has advanced.
I also saw hand therapist and staples taken out being day 9 for surgery they are very happy with my process of my rom , told they are happy for me to remove my cast at night when relaxing as long as its not for to long and not why I am walking around. Hand massage therapy starts Tuesday next week so that will be day 13.
Only using panadol for sleeping now and icing when required ;)
Will let you know how next week goes ;)
So sorry to hear your news, after all you have been through you really did not need this on top. So what therapy from here on ? I had my MRI , ultra scan, X-rays and Emg conducted today on left wrist so now have to wait until I see hand specialist to get full results but have had confirmed same issues as right. So next week I will find out surgery details etc. Had a few issues with my arm swelling around the plate area which has caused a bit of pain , so hoping that will settle down soon as makes the split hard to wear at times, did this happen for you ?
[QUOTE=BurtG;5174035]So sorry to hear your news, after all you have been through you really did not need this on top. So what therapy from here on ? I had my MRI , ultra scan, X-rays and Emg conducted today on left wrist so now have to wait until I see hand specialist to get full results but have had confirmed same issues as right. So next week I will find out surgery details etc. Had a few issues with my arm swelling around the plate area which has caused a bit of pain , so hoping that will settle down soon as makes the split hard to wear at times, did this happen for you ?[/QUOTE]

I talked to my PT some more about my new pain near the osteotomy site. He had me hold up my arm and showed me that my right one (that had the surgery) was a bit thinner than my left. Even though I use my right arm a lot, I guess I've been very protective of it for some things and I do have muscle to re-build up. It has been over 2 years since my original wrist injury so I know I shouldn't expect 'normal' too quickly. Anyway, he said that some pain is OK as I develop the muscles. If it gets worse, he will re-evaluate and change up my exercises so I'm not putting as much stress on the area.

Unfortunately, it appears I may be developing tendonitis in my left hand now. I'll keep icing and keep an eye on it, but I'm not happy about it after all this.

Keep us posted on your testing results and what your next steps are.

I really can't answer your question about the swelling very well. I had the plaster cast/splint on for 2 weeks after my surgery, then switched to a fiberglass cast. I know I had a lot of swelling that went down prior to the cast. I also know that I needed a new cast after about 1 1/2 weeks because so much more swelling had gone down that the cast was too loose. I'd guess you are around that same point in your healing by now. I will say that I used a lot of ice throughout the healing process, even over the casts. It made me feel better, even for a bit.

Take care.
[QUOTE=MountainReader;5174372]I talked to my PT some more about my new pain near the osteotomy site. He had me hold up my arm and showed me that my right one (that had the surgery) was a bit thinner than my left. Even though I use my right arm a lot, I guess I've been very protective of it for some things and I do have muscle to re-build up. It has been over 2 years since my original wrist injury so I know I shouldn't expect 'normal' too quickly. Anyway, he said that some pain is OK as I develop the muscles. If it gets worse, he will re-evaluate and change up my exercises so I'm not putting as much stress on the area.

Unfortunately, it appears I may be developing tendonitis in my left hand now. I'll keep icing and keep an eye on it, but I'm not happy about it after all this.

Keep us posted on your testing results and what your next steps are.

I really can't answer your question about the swelling very well. I had the plaster cast/splint on for 2 weeks after my surgery, then switched to a fiberglass cast. I know I had a lot of swelling that went down prior to the cast. I also know that I needed a new cast after about 1 1/2 weeks because so much more swelling had gone down that the cast was too loose. I'd guess you are around that same point in your healing by now. I will say that I used a lot of ice throughout the healing process, even over the casts. It made me feel better, even for a bit.

Take care.[/QUOTE]
Hi MountainReader

Sounds rather nasty you are trying to sort one thing and develop something else on top. This all must be very hard for you working as well . Is this covered under insurance for you ? Mine is all work insurance covered and know it is very costly as mine has been caused through work injury, and because of my work place with safety I can not return unless I am 100% which is driving me crazy. They have me working light duties else where part time but not the same.
So with the exercises to rebuild your arm do you go to the gym to do this or just at home ? Does your PT say how long to expect for the muscle to return to normal ? I have had all my test done this week but still have to get my MRI down as both appointments been cancelled due to machine break down so going to the other side of the city on Friday to get it done now. The X-ray shows ulna bone to long, ultra sound of the nerve showed a little thinning but the MRI is the best result. Have me PT this Tuesday so can't wait as I hate the waiting game.
My swelling has gone down a lot I think my split is causing the issues so will get it re fitted again on Tuesday as well. I will let you know how I get on after seeing my PT.
look forward to hearing from you
Kind regards
BurtG
Oh Booboo, I'm so sorry to hear that.

I agree with you. I was supposed to be able to bowl last June. It has been over a year and I still haven't been able to pick up my bowling ball. I still have some residule tenderness from the last cortizone shot too.

I know that the ulnar shortening helped some, but didn't solve my original problem completely. My second surgery helped address it more.

I forget about my wrist most of the times. I still have times when something triggers the 'zing' of pain though. I was at the shoulder doc recently and he was doing an assessment. He had me put my arms out in front of me and he pushed down on my arms. Boy was that a reminder that my wrist will never fully be normal again.

I'm wondering what else you have going on with your wrist. Have you considered getting another opinion from a different hand specialist to see if something was missed?

As of yesterday, I'm now the proud owner of a splint on my left wrist. I've never had problems with the left one before. I didn't injur it either. I just started in with pain similar to the right and it has gradually gotten worse. I went to the clinic and they put me in a splint and told me to wear if for a month and to check back if it was still sore. That was until I pointed out I'd had right wrist problems. Now, he said if it hurts after 2 weeds in the splint that I should seek out my hand specialist. :(
No I wouldn't. I have had shortenings on both arms and I now face bone grafts in each arm. It's really been difficult. My first shortening was last October (L); then February (R). In March, plate suddenly came loose in my left arm and had to be removed. The right is now coming loose. The left has a huge callous but has not grown bone. And yes, I have changed surgeons.

I've been tested for bone and parathyroid issues and my bones are healthy. For some reason, the blood supply to the ulna is vicarious and I am very petite. My Vitamin D levels are normal but my surgeon wants me to wait until it is high before the grafts.

As my new surgeon says...Good surgeons should use surgery as a last resort.





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