Your fracture may be healed, but are you still struggling with debilitating stiffness, weakness, or chronic pain? These common post-fracture complications can be deeply frustrating. We specialize in treating the complex issues that can arise after an injury, helping you achieve the best functional recovery you can.
Your fracture may be healed, but are you still struggling with debilitating stiffness, weakness, or chronic pain? These common post-fracture complications can be deeply frustrating. We specialize in treating the complex issues that can arise after an injury, helping you achieve the best functional recovery you can.
The journey is supposed to be over when the cast comes off, and the X-ray shows the bone is healed. But for many people, this is not the end of the story. Lingering complications can prevent you from getting back to your work, your hobbies, and your life. If your hand still doesn’t feel or work right long after your injury, it may be a sign that there is an underlying problem that can and should be addressed.
Stiffness is the most common complication following a hand or wrist fracture. During the healing process, the body can create extensive internal scar tissue (adhesions). This scar tissue can act like glue, welding the normally smooth, gliding tendons to the bone and surrounding tissues. It can also cause the lining of the joint (the capsule) to become thick and tight. The result is a stiff, “frozen” hand or finger that you cannot fully bend or straighten.
If your fracture extended into a joint, the smooth cartilage surface may have been damaged at the time of the injury. Even a tiny step-off or incongruity in the joint surface after it has healed can cause the cartilage to wear down much faster than normal. This leads to post-traumatic arthritis, causing chronic pain, swelling, grinding, and a progressive loss of motion.
To treat post-traumatic stiffness, a combination of procedures is often used. Tenolysis is a meticulous operation where Dr. French carefully dissects and removes the scar tissue that is trapping the tendons, allowing them to glide freely again. This is often performed with a Capsulotomy, where the thickened, tight joint capsule is surgically released. Together, these procedures can dramatically improve your hand’s range of motion. Post-operative care is just as important, if not moreso, and coordinating rehab with an accredited Certified Hand Therapist (or CHT) is a part of Dr. French’s care plan that he will assist with.
For a wrist that has become severely arthritic after an injury, Wrist Salvage Surgery offers a powerful solution. This is a category of advanced reconstructive procedures that aim to eliminate the source of the arthritic pain while preserving more motion than a traditional full wrist fusion. These sophisticated operations can provide significant pain relief and restore your ability to use your wrist for daily activities. There are a wide range of Wrist Salvage Surgery options (such as four-corner fusion, proximal row carpectomy, radio-scapho-lunate fusion, etc) which are carefully selected to reduce current pain while providing maximum longevity to wrist function.
Operating on a hand that is stiff and scarred from a previous injury is significantly more complex and technically demanding than the initial fracture surgery. It requires a careful approach with the patient’s goals in mind and a well-thought-out plan that respects reconstructive principles to navigate the challenging anatomy. Dr. French’s expertise as a Harvard-trained reconstructive plastic surgeon and microsurgeon can assist with these revision cases, safely release the scarred tissues, and help you attain a successful outcome.
