OK. I am scheduled for surgery August 20...ulnar shortening w/ TFCC debridement. I have tons of questions!!
I've read a lot of your posts and you mention long splint and short splint. By long splint do you mean above the elbow? My doc referred to long splint as up to just below the elbow and made it sound as though that is what I would be using the entire time.
Also, some of you are talking removable splints vs hard casts. My doc is saying removable splint...but my family is saying I should ask for a cast so I have more protection. The fear is that one of my large silly dogs will slam into me and to damage. Would it be reasonable (or just plain stupid) to request a cast?
My full time job involves working on computers, but my part time job is a veterinary technician. I suspect I won't be able to work part time for awhile--but can anyone tell me about the post-op restrictions and about how long it was before you could drive, return to work, etc?
Any info you can give me is greatly appreciated. I'm starting to get nervous and I still have a whole month to worry and obsess!
Hi, I had my op on Fri so not sure about the long term but can tell you about what's going on with me now. Woke up from op in lots of pain and arm in sling to reduce swelling, arm in backcast plaster below elbow, was released from hospital on same day, needed to keep arm raised for 48 hours, was in lots of pain day of op and day after, sunday wasn't too bad and not needed anything since. Had to have a cast change yesterday, because of a small amount of bleeding and me wanting to check wound, but all ok. Will see consultant next Thursday, 13 days post op for cast and stitches removal and will then be given a removable splint to wear only for confidence. Not sure about how long I would've been off work, I'm a teacher and so on summer hols. Not sure about driving either, discharge note says 4-6 weeks, but will be asking doc next week.
So far it's been much easier than expected and am in less pain than I was before the op so it's all good for me apart from a few weeks of being in cast.
Hi. My first long splint was above the elbow to prevent rotation of the wrist for the first 4 weeks then I got the short splint. They probably won't case it because they want you to continue with as much motion (flexion & extension) as possible. The longer you don't use it, the harder it is to get back. The splint is really hard so something bumping it won't be as bad as you think. I have a husband, 2 kids ages 3 and 11, 2 dogs and 2 cats. Lol, but I made it through ok with minimal bumpage. The first few days are the worst but elevation and taking your medicine every 4 hours helps. You can drive once you are off pain medicine and can use your other hand to drive, assuming you have an automatic. My first surgery, it took about 2 weeks until I drove. 2nd surg - 1 week. Advice? Take 2 Aleve every 12 hours along with your pain medicine if you don't have any bleeding disorders and can tolerate it. I am 2 months post-op today, I think. Good luck!!! Shelley.
Last edited by moderator2; 07-23-2009 at 08:29 PM.
Reason: please do not post pictures - as per the posting policy
How's everyone recovering? Mine is ok, doc pleased with it and got most of movement back, but still needed physio cos of tfcc tear which didn't get repaired. Physio worried that I might have developed arthritis in my thumb so doesn't look like I've finished with my surgeon yet.
I am now about 4 months post-op and still have occasional severe wrist pain, but only minimal pain to touch at the actual plate site. Since the dr had to redo the ulna osteotomy with a bone graft, the bone is now too short and he wants to shorten the radius as well! Needless to say, I'm really upset by this. I had a device to try to force the bones to rotate (palm down) but within an hour after doing the device I was back to the same stiffness as before. I started keeping my infant niece so there is no way that I can have it fixed AGAIN for quite some time. Ughhh.... On a happier note, the left arm ulna osteotomy that was done a year ago and plate taken out, is completely back to full range of motion! That scar is minimal, while the right arm is still tan / brown in areas. I find the discoloration doesn't go away completely until all hardware is removed. Has anyone ever heard of someone having a bone cut too short (mine was because of the graft) and having to get the neighbor bone shortened? I'm almost willing to do anything to not have this pain, stiffness and drastic loss of strength. Sorry to blab on......
Hi everyone...I was told several weeks ago by first doc that I had ulnar-sided tendonitis. 2 1/2 weeks ago got 2nd opinion and was told that I have ulnar impaction syndrome in both of my wrists due to my ulna bones being too long in both arms (positive ulnar variance). Talk about my jaw hitting the floor!! They are trying conservative treatments right now...Have long arm spint (just below elbow) on left arm and short splint on right arm and I'm taking anti-inflammatories. My pain right now is mild, but I'm afraid that I'll be much worse if I stop taking the meds and in the future. They said if conservative treatments don't work I'll need both of my ulna bones shortened. I'm so worried....any advice would be greatly appreciated!! I'm going for a third opinion on tuesday...
I hope all of you going through this are doing well...my thoughts are with you...
I've been dealing with pain in both wrists since July 2008. It took 8 months and many tests and cortizone shots to finally get a diagnosis...bilateral ulna impaction syndrome. We had already tried all the conservative treatments (rest, pt, anti-inflammatory meds, braces) so once diagnosed, the doc was ready to move forward. I had ulna shortening surgery and TFCC repair on my left wrist in June 2009 but needed to have the plate and screws re-done 8 weeks later due to non-union. The center screw came loose so my broken ulnar bone was drifting further apart instead of fusing together. That surgery was in mid-August and I was in a full arm hard cast for a month after that (3 months total in a hard cast). At first, I was very stiff and sore but pt has gotten my flexiblity and range of motion back. However, I still get a very sharp pain in the pinky side of my left wrist where the wrist meets the hand (where the TFCC is) during certain twisting motions. It has been a very slow recovery but I think that's the way it usually goes with this procedure. The studies I've seen talk about results 5 years out. How about one year out? That's what I want to know.
Anyway, I'm still hoping the pain in my left wrist gets better and will work through the pain and continue to strengthen it with pt. I still have to get the right wrist done and haven't been able to work since December 2008. I'd love to hear how others are doing since I feel very alone in dealing with this condition.
I know exactly how you feel...feeling all alone with this condition. However, I haven't had the surgery yet. I'm still struggling with acceptance issues, anxiety, and seriously bummed out feelings over the diagnosis and treatment to come (ulna shortening surgeries). I know others on this website and the Daily Nugget wrist surgery recovery website will be able to get you more input/advice.
I never had wrist pain my entire life (Iím 40 years old), until 3 months ago. I recently saw two hand/wrist specialists and was also diagnosed with bi-lateral ulnar impaction syndrome, due to my ulna bones being too long in both arms (positive ulnar variance). Right now my pain is mostly mild with splinting, activity modification, ice, and anti-inflammatories. The doctor that I really like says that he wonít operate until Iím in so much pain Iím begging him to do the surgery. I don't want to jump into surgery, but I'm afraid to wait until my wrists get really bad, as I'm not getting any younger. I worry about having the surgery now when my pain is manageable, as I'm afraid I'll trade mild pain for a long terrible painful recovery and irritating plate and screws...and I have two little kidos to take care of... I get my MRI results tomorrow.
How bad was your pain, before you had the surgery?
What was your recovery like (first week and second week...)?
Did the doctor say why the screw came loose?
Did you need a bone graft?
Can you feel the plate and screws in your arms now? Are they irritating?
From what I've read from others...regaining full range of motion takes time and patience.
What does your doctor say about your pinky side wrist pain? I'd talk to him about it...I've read that sometimes the wrist needs "cleaned up" after surgery...but I'm not too sure what that means...
We have the exact same problem (bilateral ulna impaction with positive ulnar variance). It certainly adds a complication if you have 2 young children. Are you able to work and care for them? If so, then you can probably hold off on having the surgery for a while.
I'm 39 but don't have any children and also had no wrist problems until July 2008. Lucky for me, my boyfriend of 5 years has been unemployed since January so he's been able to care for our pets (3 cats and a puppy), handle the cooking and cleaning and nurse me after my surgery. It would be very, very difficult to go through the surgery without that kind of help.
The pain in both wrists was pretty bad for me by December 2008 despite reduced activities and wearing braces on both wrists doing any minor activities. The pain just kept getting worse despite greatly reduced activity, anti-inflamatories, pt and the braces. I haven't been able to do any real housework for a year. My TFCC is perforated on the left wrist and damaged on the right. What did the MRI say about your TFCC? It probably isn't too damaged yet; however, it's probably only a matter of time. If you have the surgery soon, you can take the pressure off the TFCC before it's too damaged. Once that cartilage is damaged, it can't really be repaired fully. The doc tried to trim it but it'll never be the same. You will probably have better results if you have the surgery before it gets too bad but that might not be realistic with your responsibilities.
As for recovery, for the first week after the surgery on my left wrist I was in a splint and pretty much bedridden. After that, I was in a hard cast for about 4 weeks. About 2 weeks after surgery, I started to feel a little better and could spend some time downstairs but was still able to do very little. Apparently, the screw came loose because there was a slight bend in my left ulna bone that caused the screw to be pulled out. Because of that, I was in a hard cast for 3 months, unable to drive and on narcotic pain meds. The surgery was re-done at about the 6 week point and I was pretty much bedridden during that time because of the severe pain. I did not need a bone graft, which is due to non-union. Once they re-did the plate and screws, my bone fused together in about 6 weeks. After the 2nd surgery, I was in a full arm cast so I really couldn't over-use it, which is the #1 cause of non-union.
I thought that having my left wrist (non-dominant) done first, it wouldn't be that bad. However, there are a lot of things I couldn't do because of being in a hard cast. Things you don't even think about such as putting on a bra and putting my hair in a pony tail. My first surgery was in June and the 2nd in August so it was pretty hot in Southern CA. I was burning up all the time with the extra layers of the hard cast and really struggled without being able to put my long hair up. I ended up wearing very comfortable bras that I could sleep in and wear around the house to avoid having to ask my boyfriend to help me put on and take off my bra each day. I guess these are things that men don't have to worry about but thought I'd mention them to you. I found it very discouraging to be able to do so little and to constantly be in pain. I finally got off the narcotics in late Sept and started taking Ultram, a non-narcotic pain med. In late Oct, I was able to switch to Ibuprofin 800 and am still taking it every 4-6 hours.
At this point, the pain really isn't better than it was before surgery but I think my damaged TFCC (where the pinky side of the wrist meets the hand) is the problem. Since it's soft tissue, it heals much more slowly than bone. My physical therapist tells me to be patient and increase my activity slowly but it's hard to be helpless for so long. I couldn't drive for 3 months and still have pain for days if I drive more than a few miles. The plate and screws don't really bother me though. The doc put the plate under the muscle to help it not irritate me. Maybe your doc could do the same.
My range of motion is back and I have full flexibility. It did take time and patience and about 3.5 months. My left wrist is still very weak and I'm working on strengthening it. I've been doing pt 2-3 times a week for over 2 months. I still have to ice it daily and have lots of swelling.
I hope I've answered all your questions. I'm being completely honest with you so that you know what to expect when you have the surgery. I didn't really fully understand how long it would take to heal or exactly what to expect from a recovery standpoint. I hope I haven't discouraged you more but I didn't want to sugar coat it.
So did your pain come out of the blue like mine? or did something happen to start it? On a 1-10 scale, how bad was your pain pre-surgery, 2 weeks after, and now?
Did you have plain MRI or MRI with contrast. Mine was plain MRI...I hear that MRI with dye shows more...but is 4x more expensive.
I met with my doctor yesterday to review my MRI results. He said they were better than he expected them to be (but I wonder if they would've looked worse with the dye?).
Right wrist: Nonvisualization of the styloid attachment of the TFCC suggesting attachment tear (they didn't seem too worried about this). However, there was no evidence of soft tissue edema in this region. 2mm cyst within central portion of the triquetral bone (they weren't concerned about this and said it was unrelated). Pathologic fluid is noted within the tendon sheaths (tendonitis perhaps?)
Left wrist: No MR evidence of acute abnormality. Simple appearing cyst within the lunate (again they weren't concerned about this).
My right (dominant) wrist has been okay through all of this. It only hurts if I move it a certain way and the pain is mild.
My left wrist was the worst when this all started, so I guess immobilization with the splint and anti-inflammatories calmed this wrist down and made the left MRI look normal...it was very sore and sticking way out two months ago.
After I had the MRI taken a week ago Monday...I tried to go without the splints (while I was out of the house) and tried to go without the anti-inflammatories for a few days. I did okay for 3 1/2 days, until I went christmas shopping, lifted the stroller in and out of jeep, pushed the stroller with my 30 pound kido in it for an hour, and wrapped several christmas presents. The left wrist is swollen again now and looks almost the way it did before the splints/meds.
The doctor told me to continue what I'm doing...splinting, rest, ice, activity modification, and anti-inflammatories as needed. He said millions of people have long ulna bones and live with them (however, he said my ulna bones are extra long). He said to make an appointment with him if/when my pain and symptoms worsen. If pain and symptoms worsen, I'll need the surgery.
My pain is mostly mild, but present most of the time when I do not take the anti-inflammatories (voltaren twice a day)...I really don't like taking them...so I'm trying to go a few days off here and there (I also have the anti-inflammatory gel that I'm trying to use instead of the pills)...I'm praying for a miracle and hoping the pain magically disappears at some time...but it my heart I feel this probably isn'ty going to happen...
Not sure what to do...really want to fix the problem and put all of this behind me...but I really worry i could be worse off than I am now if I have the surgery...but I also worry about waiting...I'm not getting any younger...
I thought of a couple more questions...was your left wrist worse than your right wrist before surgery?...what about now?...how is your right wrist holding up now?
I worry that if I wait to have surgery both of my wrists might get really bad at the same time...and I'm sure i'd only be able to do one at a time...and I have to take care of my family...I will have lots of support though...my mom will probably move in with us until I feel better (although she only lives 5 minutes away).
Did you ever get cortisone shots? If so, how bad are they?
Two things I find interesting...
1. some doctors use hard casts (like yours) and some use removeable splints (my doctor said I'd most likely be in a removeable splint up to my elbow...but I'll be able to move my elbow). I ran into a 60 year old man at my doctor's office (different doc than mine though) who just had the surgery done 1 month ago. He's been in a short arm removable splint since day 13.
2. everybody's recovery seems so different...The 60 year old said the day after surgery was worst (8 or 9 pain wise) and then it dropped to a one after that (he said he has a very high pain tolerance though) I saw him 13 days after surgery...he drove himself to the appointment., looked great, could move his elbow and wrist with no problem, wasn't allowed to rotate his arm yet though)...he was helping with cleaning, cooking, and hitting tennis balls with his good arm at three weeks. He's excited to get his splint off and start strength training in two weeks.
and then I've heard others are still having trouble after one year...
so scary and confusing to be on this side of the surgery...not knowing what to do...
I had a left ulnar shortening (only left wrist a problem) in July this year and I've been really lucky with my recovery. Prior to surgery I was in a lot of pain constantly, I would consider myself to have high pain tolerance but struggled to make it through day without ice and pain relief, I had steriod injections in and around area (some to deal with tendonists) with no help to pain, I also tried splints and they helped to some extent but found was having more problems with loss of muscle tone. My surgeon was reluctant to operate but referred me to another surgeon for a second opinion and he agreed it was necessary. I had 3.5mm of bone removed from midpoint in ulnar and was repaired with a plate and 5 screws, when I woke from the operation I was in agony and needed lots of morphine, pain was then tolerable throughout day with pain relief. I left hospital that evening, much to horror of my mum and the nurse but felt I needed to go home to recover. Day 2 was painful but regular meds helped, I was up and showered by lunchtime, by day 3 I only needed a few painkillers, from day 4 onwards I only had pain relief occasionally and mostly to reduce swelling rather than to stop pain.
2 weeks post op I had my below elbow backslab removed and replaced with a removable below arm cast. My wound hadn't completely healed and so needed so treatment on that but was feeling fine by that time. Started back driving the next day - day 15 and was able to function pretty normally. At 4 weeks post op I saw surgeon again, had x-ray, all healing well and was able to have splint off permently. I have some nerve damage on radius side of hand that started after op but no reason for it. I had physio for about a month after op and have full RoM back. I have some strength loss and occasional pain but glad had op done. I can feel the plate in arm but doesn't cause too many problems, took awhile to get used to, did have some swelling in that area last week but all settled down again.
Hope this helps, good luck with your wrists.
I am so happy I found this site. I feel like i am the only person with this condition, and am very depressed over the situation.
I was wondering how long recovery was.? how long you were out of work? I may have to have this surgery done, but i am an esthetician, I do facials and waxxing. for my tfc tear surgey i was out for 4 months! this shortening surgery seems a bit more intense than that. also did you have full wrist movement post-op or was it limited? i am so scared to have this done as my lively hood lies in my hands! Any help is appreciated.
This site has helped me, mostly mentally, so I don't feel so alone. I'm happy to answer questions but it sounds like my recovery has been more difficult than most.
Do you have problems with both wrists or just one? Can you wear splints while working?
I haven't been able to work for a year; however, I had to have the surgery re-done 7 weeks post-op due to a loose center screw and I think that really impacted my recovery. They had to go back in and re-do the plate and screws, which involved drilling new and deeper holes into my wrist bone. My recovery has probably been atypical. I am still recovering from left hand surgery, which I initially had almost 6 months ago. It took a little while for me to have full wrist movement - probably about 4-5 weeks but again, I had to have surgery twice so you would probably have better results. However, I think you probably would have reduced mobility for at least a few weeks after getting a cast/post-surgical splint removed.