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tishaboo 01-26-2013 01:09 PM

Ulnar Shortening Surgery... how long is recovery?
 
I just had an ulnar shortening osteotomy & wrist scope surgery done on my right arm and wrist yesterday. The surgery was performed with general anesthesia and they also did a nerve block on my right arm. For about 12 hours after surgery my entire arm from my neck fingers were completely numb. Before the block wore off completely I began taking Vicodin. So far so good.. my recovery is going far better than I expected. I read many horror stories on various blogs about how terrible the pain is during the first 4 to seven days after surgery. I really have not had much pain & I'm very glad about that, Praise God! The only time that I do feel some pain and discomfort is when I get up and around, like going to the bathroom or just doing small tasks. I guess physical therapy will be when the real pain comes???(hopefully not:))

My questions are to anyone who has had this surgery before... how long and frequent was your physical therapy and how long did you take off work? I won't see my doctor for my first follow-up for another week and a half. So I would like to hear about your experience and your recovery process from the surgery to physical therapy all the way through complete healing.

MountainReader 01-26-2013 09:03 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Hi tishaboo,

There are a couple of us on here who have had ulnar shortening osteotomies done this year. Our postings are on the bone board. My surgery was last February. I'm right handed and my surgery was on that wrist. Had to learn to do things differently.

Healing from an ulnar shortening is the same as healing up from a broken bone. Usually about 6 weeks.

I was off work for 2 weeks. I had the splint/cast for 2 weeks to allow for the swelling to go down. Once I got my fiberglass cast, my surgeon allowed me to go back to work with some obvious restrictions. I started PT a couple days after I got released from wearing the casts. I recommend seeing a certified hand therapist.

My bone healed up well. My surgeon had hoped the surgery would take care of my ulnar sided pain. Unfortunately, I ended up needing to go back for a second surgery and they did the arthroscopic cleaning up then. I also ended up getting my plate removed at that time. I'm in PT now and have pretty much normal ROM and I'm getting nearer to normal for pronation and supination. I was just released to work on my strength more so I'm excited.

A couple things I learned:

*As long as the scar is pink on the outside and healing, you are still healing on the inside also.
*Ulnar inflammation takes a while to heal. It isn't good to "work through the pain" with ulnar inflammation. It is better to take things slower.
*Most PT for the first weeks revolves around working on the scar tissue and stretching. The exercises come gradually. Mostly they will just recommend adding more daily use of the wrist. PT doesn't hurt a lot. When it hurts, they stop. I started PT 2 times a week, then went to once a week. It takes as long as it takes. I understand that it does take a bit more PT from this surgery than from some other broken bones.
*I was more worried about repeat injury to my wrist than my surgeons were.

As for the pain killers, I used them regularly for a few days. I then weaned back off them. My surgeon asked if I wanted a refill. I initially said no. Then when they put the permenant cast on I realized I might need to take a few more. It took me a couple days to adjust to it.

Make sure you are constantly keeping your wrist elevated well above the heart for several days. I got really good at propping up on some pillows to help.

I also found that keeping bags of crushed ice on the splint or cast. I put a new bag on every hour or so for the first while. If you keep it on long enough, the cold does go through the splint/cast and helps with the pain and swelling. I actually continued to do this on and off for several weeks when things started hurting some.

As for the arthroscopic surgery, it appears to be much easier to heal from. I didn't have a tear repaired though. If you repaired a tear, it may be 6-8 weeks before you can start PT with it as well.

This may be TMI, but I'm going to offer it up anyway. If you are regularly taking pain meds, I recommend taking something for constipation. According to my doctor, the pain meds will "stop you like Hoover Dam". He was right. My surgeon prescribed Dulcolax and it didn't work at all. I called my GI doc and he recommended taking a double dose of Miralax until I was good, then going to a single dose while I was on the meds.

I found a great Cast Shield on the internet that allowed me to shower even with the splint on. It was made of latex and rolled up over my splint or cast and up my arm. It stayed in place by itself and even with daily use I never had a drop of water get in. I had to replace it every week or so when it started stretching out, but it was well worth it. I was easily able to use it one handed and I felt so much better being able to shower and clean regularly by myself. Sponge baths just aren't the same.

As a female, a good front hook bra is doable with one-hand when you are ready. They are just a bit hard to find. I know I felt better when I was able to dress a bit more normally. Most people don't talk about things like that, but I thought I'd offer that up.

I know this is a long answer, but I hope it helps. My story has been a bit atypical, but as of now, I'd say I'm pretty happy with my progress.

Wishing you well in your healing.

tishaboo 01-27-2013 09:03 AM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Mountain Reader,

Thank you so much for your answers! It was not too much info...it was a wonderfully thorough answer and exactly what I wanted to know. I have an office job and my surgery was on my right arm/wrist, so since I'm right handed I'm a little concerned that I'll be off work for several weeks.

I'm going to take your advice about the laxative. Reading your response reminded me that I haven't had a bm since my surgery.

Thanks again!

MountainReader 01-27-2013 10:28 AM

Re: Ulnar Shortening Surgery... how long is recovery?
 
I got myself a wireless mouse for work that allowed me to manipulate things left handed much easier without having to pull the corded mouse around.

As the healing progressed, I was able to do some light typing with my right hand. I was pretty much "winging it" with my right elbow when I did this though because I had to hold my arm in a funny position to get the right angle when I typed. It also threw my shoulder off a bit which wasn't good since I had shoulder surgery a couple years ago. Basically, there are things you will be able to do with your fiberglass cast, but just try not to overdo it.

Good healing.

tishaboo 01-29-2013 06:14 AM

Re: Ulnar Shortening Surgery... how long is recovery?
 
I should've taken your advice about not overdoing it. Since I haven't had much pain since my surgery, I got a little ambitious yesterday and did a little too much. I did a little shopping, prepared meals for the kids, and was just up and about most of the day yesterday. Last night I paid dearly for it. Not only did my hands & fingers swell, but it also felt like my arm swelled underneath the cast ..it felt extremely tight and I was in so much pain! I was lucky to get four hours sleep if that. Every time I dozed off, I kept waking up with the pain. It drove me nuts! So I guess I learned my lesson about overdoing it. For the next few days I'm gonna sit tight and chill out.

Again, thanks for sharing your recovery advice and experience with me.

tishaboo 02-04-2013 03:13 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Thanks (for the hug of support)!

I saw my surgeon for my first follow up today. They removed the post surgery dressings and splint. They also removed the stitches from the three arthroscopic incisions, but left the stitches in the long incision above the plate..they're sub-cutaneous sutures. I was fitted for a plastic mold that will be like a cast, except it's removable (for showering and PT exercises). I'm VERY glad about that because the skin on my arm is very dry, itchy and peely. Plus, using that cast cover was a pain in the patoot!

The entire process was painful and uncomfortable and I couldn't wait for them to get that mold on and leave my arm & wrist alone. I had to take a vicodin when they were done...it was throbbing from all of the aggravation.

I start physical therapy next week...I'll be going twice a week. If it's anything like today...yikes! He wrote me off work for another month (totaling 5 weeks off). I'll also get another xray in a month to check bone alignment and fusion. He said it'll be about 12 weeks before I begin to feel back to normal.

MountainReader 02-04-2013 08:53 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
I find it interesting that so many doctors can have so many different approaches.

I was in the hard fiberglass cast before getting a removable splint about 4 weeks later. I also didn't start PT until around week 7. My PT told me that the PT for the ulnar shortening can be a bit more that for some other therapies.

When I went from my initial splint after surgery to my first cast, I had to go back to a couple days of taking pain killers again. In fact, my surgeon had asked me if I wanted a refill of pain killers and I had declined. I had to call back the next day to ask for them. It took a lot more out of me than I expected. It did calm down some after a few days though.

Personally, I expect that at 12 weeks you will be doing most things you did before. You probably won't be 100% normal though. According to my 2 certified hand therapists I've visited, it could take up to a year to fully heal.

Please keep us posted on your progress. It would be great to have a good success story on the boards here.

Take care.

tishaboo 02-05-2013 02:50 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Sounds like they're trekking me down the assembly line! :-) lol! To be honest I was a little uncomfortable about how fast things are moving along. But I assume since he's a well respected surgeon and has been doing this for long time he knows what he's doing, so I will just follow instructions and hope things turn out for the best. I will definitely keep posting my progress. It looks like it's going to be a long and interesting journey.

tishaboo 02-13-2013 07:48 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Happy Valentine's Day! I had my first round of physical therapy two days ago, roughly 2 1/2 weeks after my surgery. As expected I was quite stiff. I could bend my wrist forward about 30 and backwards only 20. I could twist my hand palm down about 65% of the way, and palm up only 10. I could make a loose fist, but I could not get my pinky finger touch the palm of my hand without pain.

For the next few days I did my exercises as instructed 3 to 4 times per day.

In today's PT session I did much better! I could bend my wrist forward 45 and backwards 40. I could twist my hand palm down about 75% of the way, and palm up 20. I could sill make a fist...this time I could close my fist with my pinky touching the palm of my hand.

My physical therapist said that I am doing very well considering that it has not been a full three weeks since my surgery.

I am a little sore this evening, but I expect that considering we did push it a bit more today.

After reading all of the horror stories I prayed about my surgery and recovery before hand, so I thank Jesus for how well everything is going!

MountainReader 02-13-2013 08:12 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
That is incredible progress!!! I wonder if starting PT so quickly instead of wearing a cast for 6 weeks is helping you with your good gain of ROM. It was so much slower for me, but I was in that cast for so long that it must have contributed to making things more difficult.

I'm very happy for you. :)

tishaboo 02-19-2013 07:44 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Thanks & I agree... I think that moving sooner than later is a big contributor to my progress. I can't imagine how stiff it would've been after 4 weeks in a cast! PT, however, has been more challenging lately. She's pushing me a little more each time and I'm having more pain later in the day...and sometimes the next day too! It seems like I'm in more (nagging) pain now than the immediate days following the surgery. But I've still managed to stick to my stretches and ball exercises 3-4 times a day...except for one day when I was in too much pain to do anything but prop my arm up. Despite the good progress I still haven't gotten beyond the swelling with activity. That still makes my wrist and arm ache, and sometimes it burns right along the incision. I hope that crap stops before I have to go back to work!

I have to keep reminding myself that this is going to be a long journey, but that doesn't stop me from getting frustrated sometimes :( . The PTist said that some people never get back 100% supination...ugh...didn't like the sound of that! I have a sneaky suspicion that this hard metal plate on the bone has a little to do with it. Most of the time, when I try supination, it isn't pain that stops me. It's this weird, stiff, pulling/tugging feeling in my arm that stops me...like someting terribly wrong will happen if I keep going. So I stop. I think it's the plate. I think I'm gonna get it removed as soon as I can.

But overall I'm happy that I can drive and put my hair in a ponytail....baby steps :)

MountainReader 02-19-2013 09:52 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
I've now had 2 hand therapists. After my second surgery at Thanksgiving, I switched to a certified hand therapist closer to my work. He has made it very clear to me that while most of the time they want you to push through pain, it isn't recommended for ulnar wrist pain. Evidently it takes a long time for healing and pushing through the pain could actually aggrevate the inflammation. His advice every visit was to do what I could but not to push too hard. I've actually had more success this time.

I never regained my supination after my ulnar osteotomy last February. It was a point of endless frustration for me. I had full ROM before surgery, I just had pain with some movements. After I had the second surgery where they cleaned things out arthroscopically and removed my plate I'm feeling much more hopeful. I'm close to achieving a full palms up. After the PT works my hand and it is all loosened up, I'm able achieve the palms up. I'm not certain how much the arthroscopic stuff factored in last time, but according to my surgeon this last time the plate could have very much made it tougher before.

Thanks for the updates. I think it is good for you and also good for those reading the boards. It helps to be able to see multiple perspectives from those going through this.

Take care.

MountainReader 03-03-2013 10:28 PM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Hi tishaboo,

It has been a couple weeks. Just wondering how you are doing.

tishaboo 03-09-2013 08:11 AM

Re: Ulnar Shortening Surgery... how long is recovery?
 
Hello!

This week has been a little busier than usual...I'm back to work and I had a visit with both the surgeon and the physical therapist the day before my return to work. I had an x-ray to check if the bones are joining...and they are (yay!). I was a little concerned that they wouldn't because I've read that overuse could inhibit healing, and I started PT only 2 weeks after surgery. I can bend my wrist fully forward, almost fully backward (about 50 degrees). On a good day I can fully pronate, and supinate. However, my joints are really flexible, so although I can turn fully palm up and palm down, I can't over-rotate the way I can with my other hand. There is also still some resistance when I go palm up, so on my stiff days I can only go about 10-20 degrees shy of full supination.

My physical therapist thinks I'm doing so well that I'm only going once per week now. Now that my bone is joining I will begin working on strength in PT next week.

The doc said that I don't have to wear the splint anymore, but I still wear it when I'm at work and on the go. I tend to get careless and jam/bend/wack it when I'm not focused on being careful...and it HURTS! The bright purple and pink splint reminds me to be careful...it says "Hey...remember me? Your broken arm? Please be gentle!" Around the house I don't wear it, and I slept without it on for the first time last night. It was kinda liberating :) I don't go back for another follow-up till next year, unless I have any problems before then. He prefers his patients keep the plate in at least a year before having it removed.

The only complaint that I really have is that it seems to be tender and sore, like all of the time. I guess that's to be expected since I'm using my hand/arm more and without the splint. I still don't use it much at work. I took your advice and got a wireless mouse so that I can use my left hand mostly. I tried typing with my right hand a little Friday and my arm and wrist were aching and stinging pretty badly by lunch time. By that evening it was pretty swollen and irritated so I iced it pretty good, took some Advil PMs and called it a night.

I guess this is as good as it's gonna get for a while... until it heals completely. I'm just glad to be back to taking care of myself (unassisted) again. I'm glad that I can do my daughter's hair again (she has a LOT of hair), and I'm really glad to be back to work!

tishaboo 03-11-2013 07:01 AM

Re: Ulnar Shortening Surgery... how long is recovery?
 
I'm doing much better. In PT, after heat and ultrasound I can fully supinate on a good day, but most of the time I can supinate all of but 10-20 degrees. I can fully pronate, and I can bend forward and backward all of but 10 degrees. The therapist takes measurments to gage my progress, but I just compare my gimpy wrist to my good wrist to gage my own progress. My good wrist is very flexible and hypermobile, so I still have quite a ways to go to get that flexible again. I'm no expert but I don't think I'll ever get that flexible again until my plate is out, but time will tell. I begin working on strength this week. Given the number of times I've jammed/ bent/pulled my wrist at home/work, I doubt that the strength exercises could be nearly as painful as my own bloopers :)

Before I returned to work last week my doc did an x-ray and confirmed that my bones are joining (yay!). He said that I don't have to wear the splint anymore but I decided I'll still wear it when I'm out and about, and when I'm sleeping. When I'm busy doing things or sleeping, I don't pay attention to what I'm doing with my arm and I've had a few painful bloopers that resulted in a few days of pain and swelling. I kind of need that bright little thing to remind me that my arm is still broken! It also lessens the damage of my carelessness by keeping my wrist from bending too far or suddenly when I jam it. Until my bone is fully healed and I'm not constantly sore and subject to swelling anymore, I will be using my splint! I'm no expert, but my pain tells me (loud and clear) what I need to do. Besides, my PT is going very well and it has not seemed to hinder my progress...better safe than sorry :)

Overall, while I'm seeing steady improvements, I still get frustrated by the fact that most activity, even light activity, still seems to make it swell and hurt. I know that's a normal part of healing and getting it moving again, but it's nonetheless frustrating because it makes me feel so limited. However being able to bathe myself and do my own hair (with two hands!), drive myself around and work again far outweigh any frustration. I can't articulate how wonderful it is to get back some independence!


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