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Physical Rehabilitation Medicine/3 months post wrist fracture with plate/screws

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QUESTION: Hi Brian,
I first want to thank you for helping with my prior question about getting PT for my wrist.  I saw my surgeon 2x post surgery.  He told me with all I do daily, that would suffice and I didnt need therapy.  Anyway, it has been just about 3 months.  The other day I noticed increased pain on the thumb side of my wrist.  The worst is parallel to my surgical incision, about an inch or two below thumb. It is now very swollen, and I am getting shooting pain.  Very tender to touch, and redish.  My wrist is more stiff than even before.  Should I make an appointment to go back and see ortho?  Do you have any ideas whatthis could be?  I'm having trouble with anything that involves my right hand.  Even sleep is difficult.
Thanks again!
Chris

ANSWER: That sounds like DeQuervain's stenosing tenosynovitis.  Look it up.  Yes I would go see ortho but I'd recommend someone board certified in hand and upper extremity surgery.  Also, if you can find an over the counter thumb spica brace at Walgreen's etc it may help.



---------- FOLLOW-UP ----------

QUESTION: Brian,
You hit it on the nose. It was  DeQuervain's tenosynovitis.  He injgected
a cortisone shot with noviacaine.  He said he was stunned at my pain threshold.  But, he may need to go back in surgically and cut the band .
.

Answer
Glad to hear it.  I'd still suggest getting an OTC thumb spica splint to rest the inflammed tissue (muscles of the first dorsal wrist compartment) and allow it to heal.  The good news is that it's a relatively easy surgery if you have to have the compartment released.  Just make sure you're going to a good surgeon.

Good luck!

Physical Rehabilitation Medicine

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Brian Neville, OTR/L, CWCE

Expertise

I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!

Experience

10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Organizations
Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

Publications
RSD article

Education/Credentials
Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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