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complex ortho problem

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Old 05-11-2012, 10:35 AM   #1
Join Date: May 2012
Location: Lexington Park, MD
Posts: 2
Help4OldMan HB User
complex ortho problem

Hi folks - I’ve got a multidimensional problem happening with my right arm (hand-wrist-elbow-shoulder).

At little background - I have been a pretty active person all my life. I am a placid aerospace engineer during week but also physically a weekend warrior. I have had a history of periodic symptoms of Thorasic Outlet Syndrome (TOS) for about 18years (I am now 46). The TOS symptoms have occurred with varying degrees of severity depending on my level of activity. In 2003 an orthopedist pegged my hand-arm-shoulder symptoms as TOS but the venogram came back negative at the time and a cortisone shot in my shoulder along with physical therapy and reduced activity seemed to calm things down. My arm would still go half numb and turn blue with hand swelling when I road my dirt bike or did any overhand throwing but the symptoms would improve after a week or so of rest.

More recently in the Fall of 2010 I made a big mistake of trusting a colleague at work to show me what I thought was to be a (no force) demo of a Jujitsu hold…he told me to relax my hand and arm so he could show me the proper grip and assured me that he wouldn’t hurt me…then he started cranking my wrist way back via my two primary fingers…lasted about 10 seconds. I was pleading about 1/2 a second into it stop-stop-stop-your-hurting me-your hurting me-you are hurting me-stop-stop-stop. After my elbow popped and my knees buckled (involuntarily) he finally let go. I blasted him – you fu__ed up my arm you fu__ed my arm. His response – ya should a went down dude- then he walks off real fast down the hall. DAMAGE DONE just like a car wreck. I didn’t see this one coming. It started out casual but he switched gears on me in sick way. I don’t think he even knows why he went that far. No I didn’t document this incident at work because I was kind of in denial about how much damage there really was. I initially thought he just sprained the crap out of my wrist.

At the time my wrist was the main thing killing me. I went to see an orthopedist several weeks later after I noticed my extensor tendon of my middle finger started snapping over the main knuckle, a tendon my elbow started snapping and, wrist and elbow started clunking along with my shoulder when doing various activities.

In the spring of 2011 my ortho Dr. administered a cortisone shot in my wrist and ordered an MRI of my right shoulder and elbow. The shoulder MRI report described my long standing moderate bone spurs and extra fluid in the joint and some tendonitis but didn’t mention any tear, however my exams indicated a supraspinatus and or teres major/minor tear. The cortisone helped my wrist pain out a lot, to the point that I could start using it again because I really needed to finish work on clearing a piece of property along with several other renovation projects. My shoulder ached a little more than normal but not enough to stop me from working. Regarding my wrist, I couldn’t swing a hammer but could still use a screw gun and lift things.

My knuckle/tendon, wrist, and shoulder threw in the towel about a month ago after taking down several big trees (climbing jobs). The doctor operated on my 3rd knuckle/tendon two days ago and my shoulder surgery is scheduled for the 30th of this month. While performing surgery on my knuckle/tendon my Dr. said he reviewed my old MRI and he said that there was a small tear that the report didn’t capture… I know that tear has since opened up over the past year as I am starting to really feel it. My TOS symptoms surged as well but have declined a bit. I am hoping that the TOS symptoms will be history after my shoulder repair and rehab. Still having daily periodic tingling in my pinky and ring finger and my thumb still twitches off and on.

I think my 3rd knucke/tendon will resolve over time because the Dr. said there seemed to be little damage to the tendon where it rides over the knuckle, but I still have nasty tendonitis happening from just below my knuckles down across the back of my hand/wrist. The back of my wrist still burns like dry ice across the back and whenever I try and use it it still doesn’t feel stable during gripping activities with motion involved. My Dr. says I don’t need an MRI of my wrist, but his exam is really based on static loading tests. My wrist is currently worse off than it was after the initial injury over a year ago. My elbow tendon still snaps at about 95deg bend and the joint aches and is still stiff at night. The head of my radius is still a little loose where it ties into the ulna at the main elbow joint.

My Dr. says my wrist and elbow will get a good rest following the shoulder surgery. He also says that my elbow doesn’t warrant surgery unless there is more pain or loss of motion/function. The latest x-rays show some arthritis in my 2nd and 3rd knuckles and a little bit starting in my wrist? I fear that I have been doing more damage to everything over the last ~14 months, with everything hitting critical mass about a month ago from those tree jobs.

I have been told by friends to go to a hand specialist for any further hand/wrist issues. My current ortho Dr. may be right about the approach for my elbow, but I am really concerned about my wrist.

I have over $150k of tools, toys, and equipment that require my right hand to operate and much more invested in properties that I need to work on and move when the market recovers. I have had to shut down all my activities over the last month and will likely be down for at least 2 more months with the shoulder. Along with my shoulder I’ve got to get my wrist and hand back as soon as possible, but I don’t want to hose myself for life either. Even with my shoulder issues my right arm use to be really strong, now it has lost about ¼ of its muscle mass and ½ of its strength… I keep telling myself to remain positive.

A few things that I have learned:
1) In Brazilian Jujitsu (or any other martial art) the standard protocol is to immediately release the hold when the other person “taps out” or in my case stop-stop-stop-your hurt’n me your hurt’n me!... This happened in a professional cube space office environment…not in a gym with mats on the floor...
2) Because my joints were totally relaxed and at their stops when the loading started, they were much more vulnerable to injury.

I have been in hard core auto and motorcycle accidents before and I have never had an injury like this that doesn’t get better over time.

My Dr. says maybe you are using it (right arm) too much. However, I would think that I should be able to do a few tree climbing jobs after 13months without my wrist turning black and blue on me afterwards – right? I didn’t have any significant pain during those recent activities, but the day afterwards I was toast. My response to my Dr. should have been that my (baseline) left arm/rand/shoulder have been getting more abuse than my right has been and everything attached to my left arm remains just fine...

How long can it take for a hyper extended wrist and partial elbow dislocation to heal up?

How long do I immobilize my wrist/hand before I can try rehab and put it to the test again?

Last edited by Help4OldMan; 05-12-2012 at 06:50 PM.

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