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.
So Sunday I was using the auger putting posts in and the auger got loose from my hands and the throttle got stuck and came around fast hit my ulna right in the pain spot. swelled yada yad yada, so i monday the pt fit the exos for me, and now i cant make a fist without my wrist hurting really bad, im unsure at this point.
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?
Ive noticed the top bit of my scar and arm is numb. Where the bone sticks out on arms its from there to the top bit of the scar and abit surronding it.
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Well went to second opinon and the dr who did my ankle wants to do my wrist. He wants to do ulnar shortneing and tfcc. splint then cast for 6-8 weeks then pt. Is it a long arm cast or short? Whats the recovery? Will I be able to keep working? How many days will I need before returning to work.
Well went to second opinon and the dr who did my ankle wants to do my wrist. He wants to do ulnar shortneing and tfcc. splint then cast for 6-8 weeks then pt. Is it a long arm cast or short? Whats the recovery? Will I be able to keep working? How many days will I need before returning to work.
I just needed debriedment and not a full tfcc repair so I can't speak on that part of it. with the ulnar shortening, i had the splint for 2 weeks, then the fiberglass cast. My doctor cleared me to go back to work when I got the cast on. I was driving and working that day. I was also using the computer some, but ackwardly. I had a short arm cast. I'm not sure if they do a full TFCC repair which length you would need. I know for UT split tears in the tfcc area, it is an elbow cast.
Ive noticed the top bit of my scar and arm is numb. Where the bone sticks out on arms its from there to the top bit of the scar and abit surronding it.
My PT's did ALOT of work on my scar for months. Ultrasound, iontophoresis, massage, etc... They spent much more time on that than they did the ROM development. it seems like they were worried about the scar not healing well or forming adhesions I didn't want under the skin. I wonder if some good massage or ultrasound would help you?
I'm still having a bit of a nerve kind of issue where the doctor gave me that cortisone shot. When I push on that area, it zings across the back of my hand. The only thing they recommended was desensitation massage. It has helped some, but not a lot. I'm not sure it is worth paying for PT at this point. I have too many medical bills as it is.
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.
The following user gives a hug of support to BurtG: MountainReader (04-30-2013)
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.
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
I have shoulder hypermobility and tend to get tendonitis/bursitis/trigger point knots at times. With wearing the wrist splints and casts for 10-11 months over the last couple years, my shoulder was very unhappy. I was finally cleared last month from the wrist doctor to begin PT on my shoulder.
I started last week. I had my 4th appointment today and realized I have pain in my arm, around the area of the osteotomy. When I was in wrist therapy, they just had me doing exercised directly in the wrist area and not for my arm. I asked my PT. He pointed out that one arm is a bit larger than the other in that area. Since I've been protective the arm for a while, I hadn't realized how weak it had become. Makes me realize that I'm in the middle of a long journey.
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 ?
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 ?
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.
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.
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
Re: Ulnar shortening 
