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Hand & Wrist Care: Recovery for Fractures, Carpal Tunnel, and Arthritis

News / January 1, 2021

Healing from a hand or wrist injury helps you regain your mobility, but you should never rush the process. No matter how smoothly treatment progresses, what you do outside of the orthopedic clinic is just as important. 

As leaders in orthopedic care, our surgeons at APEX Orthopedics & Sports Medicine ensure each patient has the necessary tools. Whenever you have a hand or wrist injury, Dr. Valerie Deardorff can diagnose and find the best treatment option for your needs. For her, patient education is the cornerstone of her practice, and that includes understanding guidelines for hand and wrist recovery. 

Learn more about hand and wrist conditions and FAQs →

For more information, keep reading for our in-depth guide.

Understanding casts and splints

Most hand and wrist conditions don’t require surgical intervention to heal properly. Casts, splints, and even braces help stabilize the bone enough for aligned regrowth. Once diagnosed, your physician will first place padding around your injury, then roll casting material over the padding. Keep in mind, the area will feel warm as the cast hardens. 

How does a cast work?

A broken bone creates a gap at the fracture site. Bone healing cells have to jump across the gap to knit the bone together, but if the bone constantly moves, those cells can’t cross and heal the fracture. A cast (or even a splint in some cases) holds the bones  together so healing can continue properly. Without a cast or splint, bone healing cells will build bone everywhere due to too much motion. As a result, healing could take a lot longer. 

 

Problems that could come from a cast

As with any kind of treatment, wearing a cast may come with problems, though complications are rare. To avoid issues, never reach inside your cast to touch your skin, even if you itch. Doing so could break the skin and cause an infection. 

Signs of infection include:

  • Drainage from the skin under the cast
  • Pain
  • Fever
  • Redness
  • Bad smell under the cast

In some cases, swelling occurs under the cast. Signs include:

  • Severe pain that doesn’t go away
  • Numb fingers
  • Inability to move fingers
  • Discolored fingers

Important note: Most casts shouldn’t get wet. If you have a plaster cast, water will cause the material to fall apart. On the other hand, fiberglass casts won’t fall apart; however, getting the cast wet could seep into the padding and start to smell. Wet padding can also hurt your skin. In some cases, you may be able to have a special cast and liner that allows you to get the cast wet or even swim. 

Hand and wrist fracture treatment and recovery

There are a variety of hand and wrist fractures, but the most common are distal radius fractures and scaphoid fractures. Each come with their own symptoms and recovery instructions. When you visit Dr. Deardorff, she will provide more specific directions based on your condition and needs. 

Treatment options for distal radius/ulnar fractures

Non-operative: If your fracture is stable enough, a cast will probably work to promote properly aligned bone healing. Dr. Deardorff typically keeps her patients in casts for 6 to 8 weeks, and during that process, she closely monitors healing via X-ray exams. After your cast is removed, Dr. Deardorff will outline activity restrictions you should follow for about 4 weeks.

Operative: If your fracture is in poor alignment and you opt for a surgical treatment, Dr. Deardorff will make at least one incision in the forearm/wrist area to realign the bone. After surgery, your sutures will remain for approximately 10 days, and you will wear a cast (or wrist brace) for around 6 weeks. 

To promote healing, Dr. Deardorff recommends you take Vitamin D and obtain enough calcium from your diet each day. In addition, you should avoid:

  • Smoking
  • Tobacco products

It is also important to move your fingers and perform the provided 6-pack exercises. When you visit APEX for distal radius/ulnar fractures, we will supply resources and documents to guide you through the healing process. 

Treatment options for scaphoid fractures

Non-operative: The bone may take 8 to 16 weeks to fully heal inside a cast, and you will need a CT scan to ensure the bone is healing. 

Operative: If surgery is your best option, you will go through an outpatient procedure. Surgery typically involves placing a screw across the bone. After surgery, the fracture may still take 8 to 16 weeks to heal, though some people get into a brace quicker to regain mobility faster. You should avoid NSAIDs and nicotine to ensure healing goes smoothly as possible. Even after healing, you will probably require physical therapy.

Follow-up appointments for hand and wrist recovery

Hand and wrist fractures often require more follow-up visits than other conditions, especially unstable fractures. Dr. Deardorff often takes X-rays every week for about three weeks until the bone starts to heal. That way, she can make sure the injury doesn’t displace or worsen. The last thing you would want is to find out six weeks later your wrist is crooked and needs further treatment. 

After the initial three weeks, Dr. Deardorff recommends follow-up appointments either three weeks later or after 10 days, depending on healing progress. At the end of the day, the number of follow-ups depends on the fracture’s stability. When you visit APEX for treatment, you will receive individualized care based on your unique needs, lifestyle, and goals. 

Carpal tunnel syndrome treatment and recovery

Carpal tunnel syndrome is a type of nerve compression involving the median nerve (one of two major nerves in the hand). In an ideal anatomical course, nerves travel in smooth tunnels cushioned between muscles, ligaments, and bones. When those spaces around a nerve narrow, it can cause nerve compression and irritation, leading to pain, numbness, and weakness. 

Treatment options: 

  1. Wrist brace at night to decrease pressure on the nerve
  2. Nerve conduction study
  3. Steroid injection
  4. Surgery

What to expect for surgical treatment 

If conservative options don’t alleviate pain, surgery may be your best treatment option to relieve pressure on the nerve. Carpal tunnel surgery at APEX is an outpatient procedure, meaning you will be free to recover at home. 

After surgery, you will wear a bulky dressing, but you can move your fingers immediately (do not overuse your hand). After three days, Dr. Deardorff removes the bulky dressing and replaces it with smaller gauze. At this time, you can get your wound wet in the shower. 

Once you hit around 7 to 10 days post-op, you will be able to have your sutures removed. However, you still want to avoid heavy gripping or lifting for about a month. While your body heals, you may have lingering tenderness in the palm. After three months, the scar begins to flatten out. 

Throughout the healing process, it’s important to avoid bandaids and/or ointments because they aren’t good for surgery wounds. Rather than promoting hand and wrist recovery, they keep the area too moist to heal properly. 

Hand osteoarthritis treatment and recovery

Hand and wrist osteoarthritis causes wear and tear of the cartilage around bones, which leads to inflammation, pain, and even joint degeneration. One of the biggest differences between the hand and wrist and other joints is the number of bones. 

The hip joint, for example, is created by the ball-shaped head of the thigh bone (femur) articulating with the hip socket (acetabulum)—two pieces to create movement on various planes. On the other hand, the hand and wrist are a collection of joints; you can imagine this as a cluster of small bones working in harmony, which can make arthritis pain more complex.

Conservative treatment options: 

  1. NSAIDS
  2. Creams
  3. Glucosamine-Chondroitin (discontinue after 6 weeks if no relief)
  4. Splints/braces (distal joints may use bandaids)
  5. Steroid injections

Surgery for hand arthritis may include arthroplasty to remove the damaged joint and replace it with an artificial one. In more severe cases, a joint fusion can reduce pain, but it would also affect your range of motion. 

Returning to work after hand and wrist surgery

For many patients, recovery time and going back to work is crucial for their lifestyle. Most people typically take off 7 to 10 days, then return once stitches are removed. From there, time off depends on the procedure and the patient. 

Some procedures, such as carpal tunnel surgery, don’t require as much downtime. In fact, you could probably check your email the same day. However, some procedures may require you to take weeks away from work.

Your job is the main deciding factor on when you can go back to work. After surgery, you will receive restrictions you must follow, and if your job breaks those restrictions, it is your responsibility to make the right choice for your recovery.

Get to know Dr. Deardorff at APEX Orthopedics & Sports Medicine

Dr. Valerie Deardorff is our only hand and wrist specialist at APEX, and she completed a Hand and Upper Extremity fellowship at the University of Miami. She specializes in chronic and acute conditions of the elbows, forearms, wrist, and hands. Her practice centers around her patients, and she believes being an educator is her most important role as a physician. 

With the help of the APEX’s private practice model, Dr. Deardorff ensures each patient receives the most value that doesn’t involve hidden fees or outlandish pricing. 

The core of her success lies in proper diagnosis. An appointment with Dr. Deardorff includes the highest quality technology to pinpoint a patient’s underlying musculoskeletal conditions. From there, she can better understand which treatment will work best for you. 

For a thorough evaluation with Dr. Deardorff, call us at 913-642-0200 or schedule an appointment today.

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