Dorsal wrist bump with pain

[Zaynah]

Hi everyone!

I'm like a walking injury freak! I'm a final year physiotherapy student from SA Stellenbosch. I fell on an outhstretched hand (R) in march2007 while running to class. The wrist was sore but I taped it thinking it is a sprain. Since then, after writing many documents i have CMC thumb pain. I can't do orto tecniques on my patients, cause i cant take weight through my (R) wrist. I hurts like hell and is really sore. I have a big bump on the radial-dorsal side of my wrist in the area of the scaphoid-trapezium. I had XR taken in June, it came back negative for fractures or instability. He kept my XR which i paid for! I was told to splint it for 8weeks. The doctor looked at me and said that sometimes students in the medical profession imagine symptoms and diseases. So maybe i should forget about this and see how it goes. I thought, You Must Be Mad! So i left it there, tried to carry on, but i still cant do anyting where my wrist goes into extension and takes weigth. I cant do pushups, yoga, cant massage, do MT tecniques, cant push up to get out of bed or a chair. I went to another doctor 3weeks ago for laringitis (that's what you get working in hospitals!) and i just mentioned the wrist. He was very concerned hearing clicks and grinding with ROM and said the dorsal prominence looks like a subluxation or instability. He ordered XR again, and I hoped they will find something. It came back negative! AGAIN. So he referred me to a Dr.Wells in CPT, a hand Orthopeadic surgeon. I'm seeing him on teusday but i'm so afraid he cant find anything wrong. No one seems to know what this prominence is. I thought it was a ganglion, but when i press on it, and do a PA glide on it, my wrist clicks and it pops anteriorly into place!!! So for me it sounds like an instability! Does anyone know what is what!!!???

[matt182]

im sure the surgeon will know ;)

Sometimes poeple can miss tiny fractures of the hand becuase there hard to pick up, ecspecially scaphoid ones.

you said your radius is unstable and that maybe its effecting the radial nerve? who knows tell us how you go with the big man

[Zaynah]

I had my consult with the hand Orthopeadic surgeon in CPT panorama. He looked at my XR's took in october and saw a undisplaced fracture that has healed in my radius bone at the wrist. We now know that i had a fracture back in march that was missed for 8months!!!! Well, he ordered 2 more XR's to look at carpal bone instability (Scaphoid and lunate), aswell as an MRI for ganglions, condral injury, torn carpal ligaments or anything else specific. I haven't seen the results, but will see him on thursday. I truely hope they find out why i still have wrist pain and why i cant take any weight or pressure through my wrist? Has anyone had the same problem? I hope on the MRI they find a cause to end my worry!:confused:

[jtk73]

Not necessarily mate. I had xray, mri AND ultrasound and NONE of them picked up the tear in the TFCC I had in my right wrist!

Do not depend on these tests.

[Zaynah]

Thank goodness the MRI showed something! I had a consult with my OS today to hear the results of the MRI. I have a huge 3cmX1cm cyst in my right wrist between the scaphoid and lunate, externding all the way down to my radius bone. They have to operate asap as it's pushing the bones out of place and putting pressure on my median nerve! I'm so relieved having a diagnosis!!! I have a hip issue that is booked for arthroscopy in 2weeks time, and depending when i get off the 2 cruthes to 1, they will operate my hand (open surgery) to remove the cyst and then put me in a splint/cast for 6weeks! :)

[LONDONGUY]

Thank goodness the MRI showed something! I had a consult with my OS today to hear the results of the MRI. I have a huge 3cmX1cm cyst in my right wrist between the scaphoid and lunate, externding all the way down to my radius bone. They have to operate asap as it's pushing the bones out of place and putting pressure on my median nerve! I'm so relieved having a diagnosis!!! I have a hip issue that is booked for arthroscopy in 2weeks time, and depending when i get off the 2 cruthes to 1, they will operate my hand (open surgery) to remove the cyst and then put me in a splint/cast for 6weeks! :)


hi is there any risk that after an operation your wrist may get worse or is it going to be 100% cured after cist is removed? my wrist still hurts 11 months after injury and i cannot be bothered to get it checked out incase the doctors make it worse after operating

[Zaynah]

The problem with cysts is that they tend to reocuur. So post operative with proper wrist range of motion (joint movement) exercises and strengthening the pain will be less or totally gone. I have to refrain from putting strain on the joint so no more weight bearing through the wrist, i have to keep the hand in a fist and weightbear through the fist with a straight neutral wrist. The risks of my surgery is damage to the tendons, ligaments of the carpal bones, the radial and median nerve. But usually, with proper treatment regime things turn out good. He told me that i could get cysts in the other wrist due to compensation overuse. I just don't take weight through my wrists and i try to keep my wrists straight in neutral when doing anything with my hands or arms.

a thing to remember though. after a wrist injury one can get 'complex regional pain sindrome' aka 'sudeck's autonomic dystrophy' where the pain continues despite the healing process being completed, and then it follows 3 phases. phase 1 extreme pain with swelling, warm skin and dryness of the skin with skin and nailbed changes. phase 2 the wrist becomes cold and wet with the sweatglands being stimulated (confirms involvement of the autonomic nervous system) and the person refrains from using the involved limb. the final stage is muscle atrophy, stiffness and total disability. so it is important to get an injury checked out asap! and i you get immobilized in a splint or cast, it is important to keep moving the fingers and doing proper rehabilitation when it gets removed!

So basically, after any surgery, you must rememeber that it's not a quick fix and then you can continue with your lifestyle. you have to take care of the joints! for me that is so important being a physiotherapist. my hands are my tools.

[Zaynah]

i'm having my operation done 13 dec! i only need 1 crutch for my hip after the hip operation next week. I'm glad to have a date! will keep you posted

[Zaynah]

Change of plans.
I have osteochondritis dissecans (detached piece of cartilage and bone) in my acetabulum (hip socket) with a bone cyst in the hole. Having it operated this week. They are going in arthroscopically, and if they need to, they are going to do open surgery with bone grafts. So it's a bigger surgery than we anticipated before and i'll need 2 crutches for 4-6weeks post operative.
So now i'm only having the occult scapholunate ganglion (a cyst in the capsule and ligament of the two wrist bones) removed in mid january when the surgeon returns. I will be in a cast/splint for 6weeks and will have to organize my hospital/clinic work with the university so that i protect my hand for the 6weeks and one month there after.

[Zaynah]

Here is my MRI scan showing the ganglion (white sac):
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[Zaynah]

hi!
i had my operation on thursday morning. the operation went well and he removed the stalk of the ganglion from my scapholunate ligament and removed the entire cyst from the capsule. he tightened the scapholunate joint that was widened due to the cyst wrapping itself around my scaphoid bone and pusing it away from the other wrist bones. he managed to do all this with one incision on the top of my wrist near the thumb and dissected downwards abd around the base of my thumb... so he went in quite deep and cut three ligaments and a few places in the wrist capsule. i was under for just over an hour.

i woke up in pain... they didnt inject local or gave me anything for pain. and had a voltaren shot when i got back in the ward. i have a backslab on with bandages and tape to cover it all, up yo my knuckles and 3/4 up my forearm. he decided not to do a plaster cast as i will have alot of swelling. every hour i have to spread my fingers, bend and straighten them. my thumb is extremely sore, as the ganglion was situated at the base of the thumb where the scaphoid bone is. it is really painful to straigthen my thumb and move it in all the directions. bending it is ok. i have no sensation loss and can move all my fingers... so no tendons or nerves got damaged.

i have alot of swelling around my thumb and index finger. it aches at times and i get crawling feelings in the cast at times. i have a sling to keep my wrist above heart level, as it's not allowed to hang down at my side, as gravity will cause more bloodflow to the hand and increase swelling. so i am keeping the hand elevated the whole time and i apply a cold gel pack every few hours and move my fingers often to reduce swelling and prevent stiffness. i'm seeing my dr in two weeks time. i have to do everything with my left hand, which i'm not used to. just typing this post took almost 30min! i can start using the vingers to hold or pick up things next week. for 3months after this i'm not allowed to put strain on my wrist.... but i'm doing well. painfull and uncomfortable, but thats it. no problems or complications.

happy holidays everyone. will keep posting progress weekly!

[Kiwi]

I was just reading through your hip posts (I had a labral tear debrided in June) and read that you'd put up your wrist story here...I can't believe it, I have the EXACT same thing as you...I fell on outstretched right hand 2 years ago. The injury was initially treated as a scaphoid fracture though none were seen on xray and had it rexrayed 10 days later...there was no fracture so I was "good to go, it's just a sprain". Fast forward two years and I have had multiple hand therapy sessions, steroid injections (which have helped) more x-rays and finally after being on crutches after my hip surgery had aggravated my wrist big time, an MRI that came up with the diagnosis... "Partial width tear of the dorsal band of the scapholunate ligament with associated multiloculated ganglion and surrounding synovitis." My cyst is considerably smaller than yours at 7x5x2.5mm and I have no visible bump (occult ganglion), but the amount of pain from the little sucker is hard to believe!
All my symptoms are the same as yours...Until I had my wrist injected a couple of weeks ago (for the second time) I could not weight bear or even restrain a cat properly at work (I'm a vet nurse). The first injection gave me 100% pain relief for 4 months, and this injection has given me about 90% but still clicking and grinding...I am booked for arthroscopy of the scapholunate joint and ganglion excision on 8th February 2008. I'm a wee way behind you so am really interested to see how you get on with your recovery! I hope all goes well, keep us updated :-)
Feel free to message me through my website at www.jessmcb.com I have a dedicated 'labral tear' page and a blog about what's going on :-) I have attached pics of my pretty cyst :-)



Jess

[Zaynah]

i'm now 5 days post operative, and still typing left with slow effort and errors!!

It's going well, just the swelling, creepy-crawly feeling inside the cast with occasional numbness and tingling of my fingers. Moving my thumb is easier and notso bad as two days ago. My thumb and knuckles have turned yellow from the bruising.... my skin always gets blue, then purple-red, then greenish, then yellow when i get injured or bruised! The occasional finger numbness is due to pressure from the swelling on the nerves, and the creepy itching is from the skin's healing process.

My fingers tremble a bit when i bend them to make a fist! I'm also starting to use the fingers to hold onto small things, like picking up the serviette or helping to tie my bedroom robe. I'm only takin pain meds in the morning and at night, as i've been on it since my hip op 3 weeks ago, and i dont want to get into trouble!

Aplying ice is difficult because of the bulky cast and dressings, and i have to use a fridge-cold gel ice pack to ensure i dont get everything wet and that its soft to mold around my knuckles and thumb.

Having to keep the hand elevated above heartlevel, is tedious! The sling pulls on my neck and for comfort i pull it across my chest so that my arm is not across my body, it actually chokes you a bit! Then when i eat or sit at a tablE, resting the elbow on the table is getting sore!

It being 32degrees celsius and summer makes my hand sweat in between the fingers, makes me dizzy often, and increases the swelling! So i try to keep inside as much as possible, but not to stay in bed, as that makes the mood go down and slow down recovery.

But, otherwise its okay!! seeing the doc the 27th after christmas to check things out, maybe remove stitches and change into a splint?! Hope for the best!

Jess: It seems like occult ganglion-cysts are common after a fall on an outstretched hand without a fracture! It's a pity it takes this long to get diagnosed, and only with an mri. Good luck with the surgery. I hope my healing process and post op recovery will help as a guideline as to what to expect... arthroscopy surgery is less painfull and has a quicker recovery than open arthrotoMy (cutting & dissecting). Good luck, and happy holidays!:)

[Kiwi]

Hi Zaynah, thanks for the reply :-)
Hope you feel better soon, that must be hard-going in all that heat! You'd barely think it was summer here, we had two scorching days and rain for the rest of the week lol
Yep, the scope will have a shorter healing time...not sure why she has to make a separate incision for the cyst though? I thought she'd be able to do that through the scope. Oh well, more cool scars lol
Did you have any cortisone injections to your wrist prior to surgery? Just curios as I'm worried that since I just had one 3 weeks ago that has worked quite well (as did the last one for 4 months) that they won't find anything during surgery? Maybe I should have left it inflamed and sore lol I don't know! As I don't have a visible bump I don't know if the steroid injection shrinks the cyst or if it just helps with the inflammation?

[Zaynah]

The doctor said that the cyst is beneath the wrist capsule, originating in the ligament, and wrapping itself already around the scaphoid and radial nerve, so injecting it with cortisone to reduce the inflammation will be too dangerous because of the nerve and because the cyst was so deep it wouldnt give me the relieve it should... Sometimes the cysts shrink with these injections, but this is more likely if it's superficial, and originates in one of the tendons or the wrist capsule. Once it starts extending and widening joints, pressing on nerves etc, it has to be removed to minimize the structural damage. With the scope surgery she will have a look inside the joint. She has to find the root of this cyst where it originates, and cut it out from the soft tissue, and a bit of the surrounding tissue to remove the root and stalk. Then she has to take the entire cyst out without rupturing it, as then the fluid will go into the spaces and it will be difficult to locate the cysts' wall/capsule. The other incision will serve as entry point to cut it from it's origin or to remove the cyst intact. Mine was too big and extended across the base of my thumb underneath all the arteries and it was wrapped around a nerve which made scope surgery impossible. Apparentely the cut i have it 3-4 cm's... not too bad!

I never had any other treatment for my wrist since the fall in March... i strapped the wrist for a sprain after i injured it, and then in june when the pain got worse i was in a aliminium bar splint for 4 weeks.. but that didn't help. When we found out about the cyst, it was already huge, wrapped around bones and nerves, so i didn't have any injections or so on before surgery. My cyst didn't show a typical ganglion bump. My scaphoid bone (the bump at the palm side of your wrist at the thumb side), was slightly pushed outwards and more prominent, and my wrist was slightly thicker circumfrentially when measured. Most cysts look like balloons, but the occult ones can look like flat mushrooms and extend in multiple directions without any visible deformity.

Good luck with your surgery...:)

[Zaynah]

I'm now 2 weeks post operative and i had my cast, dressings and stitches removed. The strips of tape is still over the incision, he just cut the knots of the stitches at the ends, as they are soluble. I saw my incision for the first time and i expected it to look smaller.. its almost 4cm but looks much bigger as i have tiny hands and wrists! The doc explained he made an 2cm incision at first, but when he had to dissect all the way down to the bones with their ligaments, he decided to make it bigger than usual because of the size and shape of the cyst, and he had to do more work on the ligament. The cyst did originated in the scaphoid-lunate ligament. It was a bugger to get out coz he couldnt cut around my thumb because of the tendons, arteries and nerves, so he had to pull this here, cut a little here... But he got it all...

I'm still swollen at the knuckles and expecially my index finger and thumb... its because of the weather and because of all the work he did inside. He had to reconstruct the ligament after removing the cyst, as it was torn (aha, the cause of my cyst originally, when i fell in March! I tore the ligaments and thats why i felt a 'popping-back-in-place' sound whenever i pressed on the scaphoid and why this bone was so prominent... it was out of place!). The numbness i have in my thumb is because they had to cut close to the nerve, and because of swelling but this will come back within weeeks. We went over my rehab program, and i have 3months before i need to have full wrist movements like normal. I'm seeing him again in a months time... I have the best hand surgeon!! He is so keen in helping me, doing everything perfectly and delicately.

I got into my new aliminium bar brace... but it was so sore, as i had to push it in from the bottom, and this was so painfull. then he forgot to go over the exercises, so i had to pull it out of the brace.... ouch! everything stretching and pulling, and then back in... Enough! I have to keep everything on and still till Monday, then 3times daily wrist movements as far as i can (stopping with pain!), hold 10 sec in each position. Then weekly increase time from 10 to 15 to 30 sec hold, aswell as then 5times daily, progressing time and how many times a day as the weeks go on. No weight through my wrist, picking up patients, massaging or other physio techniques with my hand for 4 months because of the ligament reconstruction and the structures he had to cut through to get to the damn cyst! But i'm doing well, just a bit swollen, uncomfortable with a numb thumb, and sleeping positions are getting tidious. I hold objects (light weight) with the operated hand, but cant cut with knife, brush my teeth with that hand or tie my hair back in a pony tail yet... but you get used to coping and you figure out ways to help yourself.

Happy new year everyone. Make it a safe one.

[Kiwi]

Hi Zaynah,
Hope you had a fab Christmas and New Years! Thank you for your well wishes! I will post an update after the surgery. Hope the weather isn't too hot for you, it's been pretty warm here today too. How is the swelling?
Take Care
Jess

[Zaynah]

Good luck with ur surgery... and the recovery.
The swelling has gone down remarkably since i removed the brace on monday to do my exercises and then i also applied ice. It helps alot! I can make a fist and type. Moving my wrist forwards and backwards is soooo painfull and uncomfortable, but i know it will get better with time.
Take care and let us know how things went!

[Zaynah]

hi everyone

i'm now 7weeks post op after having the scaphoid cyst removed and the scapholunate ligament repaired. I'm doing well.. Saw the doc this afternoon... he measured the range of movement i have at my wrist... well i can bend the wrist forwards 30degrees (normal flexion is 80degrees) and i can extend the wrist backwards 50degrees (normal in 70-80 degrees). So i'm progressing ok. The flexing of the wrist is stiff and painfull as he cut through all the structures down to the bone at the top of my wrist, so it will take time getting the scartissue softened etc. I have to be in my brace for another month and then in a soft wirst guard with strap to still protect the joint in my line of work for about 2 months. i am not allowed to do any strainfull activities with my wrist for another 3months, and my thumb is still painfull when i move it too much.

i have no more pins and needles, the nerves are 100%. the swelling has gone down and the scar looks good. i'm massaging it lightly to get the scar mobile and soft. I'm doing all my exercises every 3-5hours daily and i'm applying heat to help bloodsupply to soften the ligaments and tendons and lubricate the joints before i do exercises.

So i'm 60% there. being a physio with only one hand is challenging!!! but i'll survive. another update soon!!!!

[Kiwi]

Woo hoo Zaynah! Sounds like you are doing really well, glad to hear the tingling has gone! My surgery isn't until the end of April now as my surgeon decided to go on holiday when I was booked in grr...but i'm doing pretty well anyway, the cortisone shot hasn't worn off yet but I get the feeling it is jussst starting to, we will see :-)

[wendyhoward]

Hello,

Do you still have pain with weight bearing, rotation and/or grip?

I am a Certified Hand Therapist and have worked for the past 4-5 years on the treatment of TFCC injuries. A majority of patients that present to me have a long history of docs telling them that nothing is wrong-"sprain- bone bruise"- dont use your hand-- ha!

Check out www.wristwidget.com for more information. Also try searching in google TFCC tears. You will find research out of Japan describing the effectivenss of a wrist splint as a treatment for TFCC tears. You can also try pushing on a scale with the elbow straight and palm flat. Take the measurement and then try doing it again with tape across the wrist tightly placed. If you notice a change in your pain-- you are on to something.

Dont give up- the wrist heals and there is a solution to your pain.

I hope that helps.

Wendy Howard, OTR, CHT

[wendyhoward]

Now that you know you have a TFCC tear- what are you doing to treat it?

Wendy

[Kiwi]

Hi Wendy,
not sure who your post is directed at? My TFCC is fine, I have a partial SL tear with associated synovitis and ganglion cyst. I am having arthroscopic surgery on the 23rd of this month to address these issues and hope for a full recovery.
I have little pain while the wrist is not in use, just find putting pressure on it and opening jars etc difficult, the scale idea is interesting!
Jess

[Zaynah]

hi...

it's now 3 and 1/2 months since my surgery. I'm still struggling with getting back all the range of movement in the wrist. I have full extension (backwards) and side ways, but bending it forward (flexion) is sooo stiff with pain at the end of the range. I was at 30degrees 8 weeks back, and now i'm at about 45-50degrees. but i only get the 50degrees of flexion after 10minutes of a hotpack with lots of massaging the scar and mobilization and stretching exercises of the wrist. without that, i only have about 20-25 actively. but i hope for the best. I use the wrist without a brace or strapping and i do everything with it, but i avoid weight bearing through it or straining it to much. I am aiming for another 10degrees increase to be at 60degrees in a months time. I want to have full range 75degrees in june... I'm not aiming for my hypermobile ranges, as this is 95-100degrees of flexion and extension on my normal wrist.. this is way too lax and the doc said not to push it so far... normal ranges 75-85degrees. so that's my aim..

so all good! sometimes i get some akward ache in the pinky side of the wrist where that small ganglion is situated at (they decided to leave it as it's not in an joint space or close to nerves/arteries)... but nothing new.

Kiwi... good luck with the surgery! Remember to take it slowely, dont push yourself... only do that when the scar itself has healed coz then you'll know the inside is healing well... Ice, elevation, protection and rest.. Try finding sleeping positions already so that you don't have to figure that one out like me after you've had the opp... many sleepless nights figuring out where to place the arm in an elevated comfortable position at night. Good luck!!!!!

[Kiwi]

Hi Zaynah,
Glad to hear that you're still improving! Slowly but surely, you will get there :-)
I have no plan of rushing things, am taking 2 weeks off work and spending one of them up north visiting my Mum :-)
The sleeping thing will be interesting, between my hip and my wrist I think I will be kicked out of the bed by hubby lol I already sleep with 4-5 pillows in various places lol I will have to experiment!
Hope you continue to heal and you reach your goals!
Jess

[Kiwi]

so with regards to the scale pushing thing, I kinda suck at it lol I think I am weak even on my good side with a reading of 26kg lol! and my injured side got 6kg...quite a big difference! Very interesting

[focus_911]

TFCC tear?! you poor thing. Those wrist injuries are so difficult to treat. The wrist is such a complicated joint, even the most experienced surgeons sometimes have trouble fixing these soft tissue injuries.

No matter what you do make sure you find the most experienced surgeon you can find. That will make a big difference as to whether or not you will be able to fix your injury and once again be pain free.

Keep us posted on your progress.

[Kiwi]

Hi Kelly,
actually it's a scapholunate tear with ganglion cyst, so maybe not as bad? I don't know :-) Had great relief from a cortisone injection but it only lasted a few weeks, at least I know I'm not crazy and can justify the surgery now :-) Will post updates.
PS how are the hips doing?? Long time no see.

[focus_911]

:cool: Hey you!

The hips have been doing well. Had an osteotomy done on my right hip last year and now just today, scheduled to have the same thing done on my left hip. Once thats done I should be good to go. Just now re-injured my wrist and was scheduled last week for surgery which has obviously been postponed to after I get my hip done...

My dear, you will see me around a lot:p

[Kiwi]

Oh NO!! That's not good at all. Crutches are hard work with a bung wrist , I think that's what aggravated mine.
Goodness another huge surgery for you, when is that scheduled for? I hope all goes well, you will be bionic woman with all your nuts and bolts hehe
Look forward to reading your progress :-)

[focus_911]

Hey, thank you I appreciate the support after all this time. I am waiting for a phone call from the surgeon's office. There is a thread in the Groin/hip innjury forum that was started over a year ago on what I've so far had to get done this far.

[Kiwi]

Ohhhh I love x-rays lol I think i've seen these pics a while ago actually. You must have buff arms by now lol

[focus_911]

it's all flab my dear, all flab...

[Kiwi]

LOL surely not!
Was just looking at that x-ray and maybe I have impingement on my brain, but it looks like you have a cam impingement on that hip?? Will the new position of your acetabulum cause any trouble?

[focus_911]

Well it has been a year now since the last surgery and even tho I do get the regular weather change discomfort, everything else has been great. I think it's going to be a few years before I am 100% but right now I am really looking forwards with good vibes:)

[Kiwi]

Excellent :-)

[Kiwi]

Well, my surgery is tomorrow. I still don't know what kind of anaesthesia will be used. I had a rough recovery from the general I had last year for my hip surgery, so may be getting an arm block instead. Have any of you had this? I thought it would be cool to be able to watch the screen, but I think I am more nervous lol Will post update in a couple of days.

[focus_911]

Good Luck, keep us posted on the recovery:)

[Kiwi]

I am home :) Typing will be fun with one hand, at least I know where all the keys are lol.
Well my joint looked good, no ganglion as such just a huge chunk of inflamed tissue that was removed and there was a piece of cartilage missing from one of the bones. The surgeon doesn't see this causing me long term issues. I have no cast, just a thick bandage. Ended up having a GA and was promised lots of local by the anaesthetist but got none! Had some good drugs in the hospital and have codeine & diclofenac for pain at home.
Can move fingers ok, thumb is a bit sore, will post updates as I go :-) Thank you all for your support!
Jess

[Zaynah]

Good luck with your recovery.. Take is easy.. elevate the arm, ice where you can and move the fingers alot, the thumb will be painfull, and it will get better.

[Kiwi]

Thanks Zaynah :-)
I think I am doing really well. I have hardly any pain, just the odd ache or twinge when forgetting that I shouldn't be using it ;) Am only taking pain relief with anti inflammatories in the morning and evening and have been keeping the wrist elevated. I haven't been icing as I am in a half cast, so the top part of the wrist is cast but the under side isn't. I am already sick of having one arm out of action and think being on crutches last year was much easier and less of a hassle lol However I am taking advantage of my time off work and visiting my Mum and really enjoying myself :)

[focus_911]

That wrap looks quite cushie. Is that what the medical staff put you in? or is that a (really nicely) put together home bandage? I remember when I get my first wrist surgery I was in a cast, shortly followed by a splint that went up to my armpit.

What is the prognosis?

[Kiwi]

HEHE it is what I woke up with in the hospital. There are about 4 layers, the first being a thin layer of swabs over the wounds (i can see down there a wee bit), then cotton wool type stuff, there is a layer of plaster of paris on the top then the whole lot is covered in elastic bandage.
I guess this way it allows room for swelling. My knuckles and top of hand are a bit swollen, but still not having significant pain which I am surprised about. I used my sling until yesterday as instructed and now that I am kind of on holiday and been sight seeing, my digital camera hanging from my neck was also fashioned into a sling while i wasn't using it lol. I have one of those unsightly white tie up round the neck slings from the hospital and I get a lot of sideways looks from people when wearing it because it stands out so much, so I am glad I don't have to wear it any more. However if I feel I need to, I will.
A cast up to the armpit sounds like a right pain in the...armpit!
Not sure on the prognosis just yet, I'm a bit nervous...will find out in a week at my post op visit.

[Kiwi]

Got the cast off today, yayyy :-) Never thought it would feel so good to wash my hand haha. I have a pretty useless hand at the moment, grip strength 3kg, flexion 17deg, extension 15deg and no measurable ulnar/radial deviation. It's going to take some time to get back to normal but I'm hoping for the best.
I've been told to regularly massage the wounds as firmly as I can tolerate do discourage scar tissue forming and have some ROM exercises and desensitisation exercises for hypersensitivity. Will have to see what the boss says about going back to work on Thursday, she's one of these "if you can't do much, you might as well not be here" type of people. I'd rather be at work earning money and have some company than being at home bored by myself. Any way, I think it's going to be a long time before I will be back to lifting 20kg dogs and bags of dog food etc!
For now I have to keep the wounds covered with tape for the next two days and wear a soft brace, have a revisit appointment in four weeks. I really miss my bike, it will be a while before I can ride again and the weather is just getting colder too, -3 celsius this morning when I got up and it's technically not even winter yet! I hope to be able to get into the pool next week, I'm feeling lazy and am a bit paranoid about losing all my fitness and putting weight on, I worked really hard to get it all off!

[Kiwi]

Hey guys,
my wrist is a little stronger but not a lot better than Tuesday. I had my first session of hand therapy this morning that felt both painful and disturbing because of the sensitive areas. I did manage to go to work six hours yesterday and have pretty much been banished to reception until it is safe for me to handle the animals properly (I'm a vet nurse), but at least I can get out of the house and earn some money. Apparently a new roster has been written up for the next three weeks to help me out but not sure what it is yet.
I have pretty much no pain at rest which I am happy about, but really need to work on my ROM and breaking up scar tissue as it is still very tight. Things are coming along slowly, but I am confident for a full recovery...eventually!

[Zaynah]

hey kiwi

i'm so happy to hear that you're doing well. the range of motion will come back with time. Give it 5degrees each week. If you apply heat for 10minutes, this will soften the scartissue and increase bloodsupply and fluid in the joints, making the exercises easier and massaging the scar better. Try to hold the posision you get at flexion and extention and then you make small bouncing movements at the end of the range for 40sek. this will help you to gain ranges as you work at the stiff-pain end of range. You can also make a fist and then try and flex the wrist keeping the elbow straigth (this stretches the long finger and wrist extensors in the forearm, the tendons runs over the fingers at the knuckles), this will be painfull, as the long finger and wrist extensor tendons have shortened and stiffened up, so you'll feel the pull...! Do the same for the long flexors, opening up the hand with fingers extended, turning the hand upwards to face the ceiling, keeping the elbow straight and then you take the wrist backwards in extension with your other hand.

Put some rice in a balloon or pantyhose to make a stress ball. Sqeezing this will increase grip strenght tremendously. if you have some swelling at the knuckles, apply ice and do alot of finger movements.

Good luck, take it slowely. Sometimes you reach a plateu where for weeks you will gain no ranges. Wait it out and just keep faith!

[Kiwi]

Hi Zaynah,
thank you so much for those ideas, they are great! I have just finished an evening at work and had my dinner so am about to do my exercises now...
I have noticed with extension I was cheating...i had my hand open and it goes further that way, with my hand in loose fist it hardly budges. My hand therapist has given me some new exercises to do and one of them is moving my hand into flexion with my opposite hand as it can go further that way, then I hold it for a few seconds. I'm not sure about the bouncing thing, it feels like things will snap apart in there as it is lol though I have been assured they won't! Flexion causes a sharp pain in the middle of the 2nd metacarpal. Will definitely try the sqeezy icy thing, it sounds more fun and messy than the spongy thing I got lol Is it ok to use heat and ice in the same session? I would use heat at the start and ice at the end.

I really appreciate all your help and suggestions :) Hope you have a good weekend

[Kiwi]

ohhh you said RICEEEE not ICEEEE haaha ;-) Duh

[Zaynah]

hey....

the ice-heat thing is just to create a sirculatory pump effect. You should only use this when inflammation has stopped, thus after the initial acute 5 days. If you apply heat you open up the arteries, causing more bloodflow to the area, increasing the lubrication of the joints and softerning structures. If you use ice, you constrict the arteries, stopping the bloodflow to the area. So if you use it 5-10 mintues each consecutively, you create a pumping effects where arteries open and close. This reduces sweling dramatically if you do massaging with it aswell. I would do some heat for warmup, then all the exercises and massaging, and then maybe heat-ice-heat-ice combo in an elevated position (hand 45degrees above the heart to aid the sirculation drainage back to the heart using gravity) for sirculation, and end off with ice for post-exercise pain and swelling.

I still get a sharp pain over the second MTP knuckle and ontop of the hand when i make a fist and flex the wrist downwards, as this strains the tendons of the long finger and forearm flexor muslces that run over the joints. It will get better as my ranges improve. Don't worry about snapping a tendon! They diddn't touch them, so they're at no risk, it just feels extremely tight with a sharp sting... that's normal. Take it easy... it sounds like you're doing fantastic. Good luck the recovery!!!

PS: i'm going back to my hip dr... its been 5months and i'm still having groin aches and stings with clicking after the scope debridement and microdrilling. such a pest... hold thumbs for th 19th May!!

[Kiwi]

Hey!
That makes a lot of sense...I'm just sticking with the heat for now, I have pretty crappy circulation in my hands and feet at the best of times lol.
It's really good having someone to talk to who has been through something similar and who also knows how things work lol
Sorry to hear about your hip :( These injuries are such a nuisance aren't they! I still have clicking, aching etc too, especially after prolonged sitting. I am not ready to do anything about it at this stage as I know there is the possibility I need another surgery and FAI scopes aren't done here yet, only open.
I hope your appointment goes well and that the issues can be dealt with conservatively. I can't remember the specifics of your surgery other than you had a bit of an odd injury? Did your surgeon achieve what he/she wanted to with surgery? Hoping for the best for you!
Jess

[Zaynah]

hi...
it helps alot to know that you're not the only one having these operations and that someone else understands what you are going through.

about the hip... i got diagnosed with a 'hole' in my hipsocket. no one was quite sure what was going on in the hole as the bone surrounding the hole had inflammtion in, and when they injected the fluid and took another MRI, the fluid didn't fill the hole, it only went into it partially, suggesting that something was inside the hole. the doctors performed arthroscopy and they found flaps of loose cartilage in the area of the hole, and my labrum was completely detached at that area. They found a thin membrane partially covering the hole, but they didn't go into the hole to see what was going on inside, they only shaved away the surrounding cartilage flaps and took my labrum away, leaving the membrane intact. They drilled some micro holes in the surrounding bone to create new bleeding to enhance healing. They just left the hole untouched, and we still don't know what is in the hole! He only saw me 10days post op, ripped of the tape, forgetting he gave me stitches (bastard!), and then never followed me up. He said 6-12weeks and then do what ever, just refraining from high impact (jogging, jumping) and major hip positions (yoga..). But since 3weeks post op i realised i reached a plateu. its now 5months, and i cant cross the leg over when im sitting, it gets sore when i just cross my ankles, it get sore when i drive or sit for longer than an hour, i struggle finding a sleeping position, and i get an odd hip snapping/clicking, when i'm just stading still and then i remove the weight from that leg or take a small step. I get groin stings when i move the hip in small ranges sometimes, and i struggle putting on my socks. I'm now really getting worried about the hip as its making me feel disabled, and i'm worried about the diagnosis... because i know all the things that this could be, and offcourse i'm expecting the worst. I'm only cycling 2times a week, swimming 3 times a week and taking my dog for walks on level ground. i'm used to be very active. last week i got a pain in the groin everytime i put weight on it and i was in a hospital and had to do stairs, and then i just dissapeared after swimming. sometimes it snaps while im swimming just kicking my lowerlegs during normal freestyle. Weird hey!! so hopefully when i see the doc in a weeks time, he will drop the ego trip and better-than-thou act, and really get to the bottom of this.

Have a great week!

[focus_911]

Keep us posted on your progress and updates. Glad to hear that in the mean time you are able to go a lot of physical activity.

Keep us posted.

[Kiwi]

Hey there, thought I'd send an update. My grip-strength is now up to 16kg! It seems so silly to be excited about that lol. I think extension was 40 degrees and flexion 15 degrees, so still a wee way to go with those. My scar is still quite tender and am finding the massaging quite uncomfortable. Am now using a theraband for extension/flexion exercises. Still have a lot of scar tissue and a bit of a bulge under the scar which I hope will eventually disappear. Am doing pretty much everything at work except lifting, just find it difficult to get my hand into a desired position sometimes :) So, still improving which is good. See my surgeon in two weeks.

[Kiwi]

It seems to have gone quiet in here, I guess that means people aren't injuring their wrists! That is a good thing!
I reached a bit of a mile stone this week, managed to get to 30kg on the grip strength test, so my grip is nearly back to normal! I have increased my flexion and extension by 5 degrees in the last week (30deg and 55deg respectively) and have a lovely physio student friend who is helping with massage. Hopefully this will help break up the scar tissue as she is much rougher on it than I am myself :) Still quite limited ROM but definitely still improving :-)
I hope everybody else out there is doing well. As they say, no news is good news!

[katrina]

I am a tennis player (not professional) & hurt my wrist July 1st. just from hitting a volley. After the MRI I was diagnosed with full-thickness tearing involving the central & dorsal aspects of the scapholunate ligament. Everything else is normal & it actually doesn't really hurt but I can't hit a tennis ball. I was just wondering if anyone knew how long I will be out for. Is it really 6 months? More? I have an appt to see the hand surgeon tomorrow but was wondering if this ever happened to anyone else playing tennis. I've been playing almost every day for 12 yrs & I've never heard of this type of injury before. It's not like I fell on my hand. I guess maybe it got bent backwards too much.

[Kiwi]

Hi Zaynah, how is your wrist doing these days?? I am 3 and 1/2 months post op now, still battling scar tissue but slowly getting better. Sleeping with an extension splint at night time as my extension hasn't really improved a lot...have roughly 55-60deg flexion/extension I think. Grip strength has improved to 28kg but depends on what time of day it is taken, if it's taken in the morning it is usually a lot less. Still can't push on hand when getting out of chairs etc but hoping that will come right as the scar tissue softens.
Hope you are making progress with your wrist and hip :-)