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  1. #1
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    Broken wrist--distal radius fracture--4 months later

    I fell backwards off a ladder, did a karate chop from h!ll behind me to break my fall and broke my wrist instead. And a distal ulna fracture as well! Those are the two major bones in your forearm. They end at where your wrist starts. Distal means "end of". Had surgery to pull the end of my radius back into proper position and place a 6" piece o' metal with 6 screws to hold it. Not having surgery wasn't even an option.

    Was in a cast for 5 weeks. Swelling took 2 1/2 months to go mostly down. My hand looked like a gnarly leather glove! My arm (right and I'm right handed) just disappeared, muscle-wise. Couldn't work out, heck couldn't even tie my shoes, and sure as sh!t couldn't ride.

    Finally the pain subsided enough I could start using my right hand, very very slowly at first till I could pick up a gallon of milk and shift my Element--whoopee!

    4 months after my fall (August 22 at 2:24 pm) I've ridden easy trails 5 times and lift weights--again very slowly, like 12.5 lb curls and 20 lb dumbbell shrugs. At first it was trying not to lift so much that my hand felt like it was going to come off the end of my arm. Now I actually have definition creeping back to my arm and strength where before there was nothing. There was nerve damage as well--my middle two fingers feel like an electric shock is running up and down them. The docs say that may never go away. When I wash my hair in the shower my hair feels like sandpaper with my right hand. Oh, well, at least I can use it!

    I'm looking forward to Moab in late March (maybe not Porc but maybe Sovereign) where in the first few months that seemed impossible. Make no mistake, the hand still hurts a lot while riding and my range of motion still sucks. I stretch 2 hours daily, still go to PT, wear a JAS splint three 30 minute sessions daily. (www.jointactivesystems.com--for all your range of motion needs, not just wrist injuries. A lot of docs don't know about these devices. See if your insurance covers one, mine does. They're not cheap to rent monthly which is how you do it, but you have six months from injury to get back what range of motion is possible. You gotta get on it NOW!) It pushes my hand backwards and the other way as well, but I really need the backwards motion the most. The turning of my hand left and right came back with the proper instructions on how to properly stretch. All thanks to my PT lady (Dona, bless her professional heart).

    I feel like I can tell you my story on this forum without sounding like I'm whining. I don't compare my current condition with August 22 at 2:22 pm (lifted regularly, mountain biked pain free a lot and a contractor/carpenter). I now compare myself with when I was in the cast, one handed (and my off hand at that!) and kinda helpless. The fact I can ride easy trails with pain, lift lightly with pain and look forward to going back to Moab and ride is kind of overwhelming, actually, considering I was just a helpless dude terrified of falling down the stairs for quite a few weeks.

    Others have commented on other threads that you probably won't be the same after rehabbing certain injuries and they're probably right. But your perspective changes to one of being grateful as heck for what you do have. Good luck, all of you coming back from injury. And try a JAS device for whatever injury you have. No, I don't work for them.
    Last edited by xcguy; 01-13-2007 at 07:11 AM. Reason: different wording

  2. #2
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    Good work on your recovery xcguy; it sounds like you've come a long way. Just remember to take it s l o w.
    Have any docs mentioned nerve reconstruction? A while back I severed a nerve in my hand that left me with similar numbness. Half of my index finger felt like raw meat and I even lost my fingerprint on that side. Doc told me that surgery, while not perfect, could help. I gave it a shot and a year later had much of the feeling back. Not 100%, but at least now I'll notice if I'm touching a red hot brake rotor.

  3. #3
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    please not another surgery!

    Quote Originally Posted by Coaster?
    Good work on your recovery xcguy; it sounds like you've come a long way. Just remember to take it s l o w.
    Have any docs mentioned nerve reconstruction? A while back I severed a nerve in my hand that left me with similar numbness. Half of my index finger felt like raw meat and I even lost my fingerprint on that side. Doc told me that surgery, while not perfect, could help. I gave it a shot and a year later had much of the feeling back. Not 100%, but at least now I'll notice if I'm touching a red hot brake rotor.
    I asked them about the tingling sensation from day one but their tests confirmed the nerves weren't severed just "shocked" bigtime. I would imagine that that you went from where your hand was to where my hand is now with your surgery. Whether or not I can go from where I am now to 100% with another surgery is doubtful, considering the risks involved with any surgery.
    I will ask my surgeon next time I see her, though, thanks for the advice. How long did it take for your hand to get back to "normal" mobility-and-strengthwise after your surgery?

  4. #4
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    an update on my progress

    It's been only a few days since I started this thread, but I've ridden a few pretty gnarly rides since then, to test things. My fitness is coming back, and even though I still walk some downhill sections that I didn't think about riding before, I can get out there and ride not just the easy stuff. The long downhill bumpy sections really hurt, but I do these in small amounts, go back to my truck and go home. Today I lifted some landscaping rocks and put them around my garden, something that was unthinkable just 3 weeks ago.

    I know some of you out there are in the same condition I was at first, but so far I am amazed and extremely gratified at my body's ability to heal. I'm trying not to do anything stupid, but I gotta say that once I was able to use my hand after the pain subsided my strength is coming back nicely. But, and this is a big but, you cannot forget to work on your range of motion. In fact, I'm going to put on my JAS brace right now. Good luck.
    Last edited by xcguy; 10-25-2013 at 04:03 PM.

  5. #5
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    After breaking the radius at the other end (elbow) in October, I am still unable to completely straighten my arm. (am missing about the last 30 degreees).

    How long can I expect it to take before I can regain most of the mobility and how often have you been stretching / excercising per day? I would really like to be able to get back on the bike by March if possible.

    Thanks for info in advance,

    Bacon

  6. #6
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    two different injuries

    Quote Originally Posted by BaconBrain
    After breaking the radius at the other end (elbow) in October, I am still unable to completely straighten my arm. (am missing about the last 30 degreees).

    How long can I expect it to take before I can regain most of the mobility and how often have you been stretching / excercising per day? I would really like to be able to get back on the bike by March if possible.

    Thanks for info in advance,

    Bacon
    You've got a completely different injury than I have. Same bone, different ends. I hope you've been going to physical therapy where you live and are following their advice. I'm working on my wrist motion and you're working on your elbow. I'm not a doctor, just an injured mountain biker. The mobility in my wrist is about 95 percent in some directions to only maybe 70 percent in other directions. My PT person says that you have to work on your range of motion in the first six months after injury because after that it's too late. I can't tell you what exercises to do to help straighten your arm but go on that JAS website I listed above and see what they have to say. Good luck. And I was able to get on the bike about 10 times before the snows finally buried us here in Colorado. I've got clearance to lift in the gym, but I'm going real slow there. Finally have my right arm back, though.

    I wear the JAS splint 3 times a day, 30 minutes each, plus I push and turn my wrist in all other directions all day when I think of it. I don't think I'm going to get my wrist to bend backwards like it did, ever. It just sort of dead ends about half way. But I'm still going to work on it daily till end of February. Other directions (turning thumb to the right and then to the left) took awhile and a lot of painful pushing to finally get that to 95 percent full range. I had to have guidance on how to properly stretch, though, I would have never done it correctly by myself. Who knows, maybe your arm will start straightening out with the proper painful stretching, but unless you're doing it correctly you're not giving yourself the proper chance for full recovery.

  7. #7
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    Hope you are back up to 100% soon. That can be a bugger of an injury.

    My mother managed a distal radius and ulna fracture when she was washing some lino at her place. She slipped, went over backwards and tried to break her fall by putting her hands out. A bunch of pins and 4 months later she is now starting rehab to regain the strength in her right wrist and hand...having seen what she went through, I can understand your pain.
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  8. #8
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    I like your "Book of MTB Revelations"

    Quote Originally Posted by Psycho Mike
    Hope you are back up to 100% soon. That can be a bugger of an injury.

    My mother managed a distal radius and ulna fracture when she was washing some lino at her place. She slipped, went over backwards and tried to break her fall by putting her hands out. A bunch of pins and 4 months later she is now starting rehab to regain the strength in her right wrist and hand...having seen what she went through, I can understand your pain.
    Behold, he who wasn't even injured while riding--that's me! I remember how many times I've launched over the bars and landed, if only for a nanosecond, on my outstretched hands, bent all the way back only to then hurtle forward in a blur of arms and legs. I'd lay there for awhile, figure that was it, I've messed myself up now for sure, but except for lots of blood and scrapes I never broke anything riding. Then I fell off that freakin' ladder.

    Now that I have broken my wrist I can picture your ma going backwards and how solid the hit was when she landed. And I can feel her pain, shock and anxiety. I bet she was right-handed, too. Everybody I spoke with said take the long view, like a year. Work on your range of motion bigtime (per the PT person's guidance) in the first six months and don't worry so much about the strength. Your muscles will disappear but are still there waiting for the pain to subside so you can at least use them, if not build them up right away.

    Some people take the loss of their former lifestyle harder than others. I would imagine a mother with a family to take care of and all the attendant housekeeping duties could take the helplessness pretty hard. Tell her that she will be able to use her hand again, and her perspective at that point will be that being one and a half handed beats the crap out of being one handed! Pretty soon, even though her mobility might not be what it was, she will feel like she is two-handed again and I bet she'll never take the ability to do that lino for granted again.

    I build houses but I'm the contractor so it was very important that I get to where I could turn my hand over enough to type on my keyboard, like I am now. I worked on that range of motion the most and thank god it came back. Now I'm thinking about the next time I launch OTB. Maybe I'll just ride real slow from now on. You gotta slow down sometime.

  9. #9
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    You've got a completely different injury than I have. Same bone, different ends. I hope you've been going to physical therapy where you live and are following their advice. I'm working on my wrist motion and you're working on your elbow. I'm not a doctor, just an injured mountain biker.
    Yeah, I am aware that you are not able to give me any truely qualified advice but sometimes I guess you just ask yourself the questions "Am I doing enough?" or "Am I expecting to much?" I find it difficult to find the right balance, especially when the results of the physical therapy are less than expected.

  10. #10
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    tough to tell when you've maxed out on range of motion

    Quote Originally Posted by BaconBrain
    Yeah, I am aware that you are not able to give me any truely qualified advice but sometimes I guess you just ask yourself the questions "Am I doing enough?" or "Am I expecting to much?" I find it difficult to find the right balance, especially when the results of the physical therapy are less than expected.
    I'm feeling my way through this therapy thing myself. I know that by using the JAS device I've probably gotten gains I wouldn't have without it, but at this point it's only adding up to a few degrees more in range. Have you gone on the JAS website? I just tried to use the link above and it didn't work. Joint Active Systems is the name of the company. Google it to get to the website maybe. The continuous pressure is a different kind of therapy. When your muscles relax from the shock of the pressure you dial in more over a 30 minute session. I see you're in Germany. Hope you can get this website up to get the info they offer. Talk to your physical therapist about these devices. I didn't use one for my wrist turning motion, just my other hand forcing it towards each direction. You'll see specific elbow devices on that website. The time to get that range is NOW. I kept asking my PT lady if there was more I could be doing. Well, if she didn't know about the JAS devices she might have said no, but she would have been wrong. There does come a point, though, where there's no more range of motion to be had, at least for the moment. I talked to a guy who broke his wrist in a short track auto race 8 years ago and he said he finally got some more flexion in his wrist back in the last 2 years. Something about hard fill in between his wrist bones breaking down. Hope that happens for me.

    You might try another PT person, see what their opinion is. I've had two. The hard facts are that sometimes it just doesn't work out like you'd like. It sucks, I know. But you can't stop trying to get back your range of motion. Like continuous therapy for the next year, even if just on your own. Don't get depressed about it just keep moving forward.

  11. #11
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    Glad you like "the book" I've seen a few good ones around and will likely be starting a collection of them before too long.
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  12. #12
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    I just traded broken wrist stories with a guy in a shop

    He did his DHing about 40 mph when he hit a "hidden" log. He said he continued to progress in his therapy for the first eight months. When I showed him my ROM he said wait till you see what's up at the 8 month point. Now he races DH like before. Got my fingers crossed.

  13. #13
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    post here if you haven't been able to contact JAS

    Quote Originally Posted by BaconBrain
    Yeah, I am aware that you are not able to give me any truely qualified advice but sometimes I guess you just ask yourself the questions "Am I doing enough?" or "Am I expecting to much?" I find it difficult to find the right balance, especially when the results of the physical therapy are less than expected.
    Really, I don't work for this company. If you haven't been able to check out Joint Activation Systems let me know. I have an email address of someone to contact there. I'm going to wear their wrist device for the next couple of months to try to get more range of motion of my wrist. Any stretching I might do on my own can't possibly obtain the same results.

  14. #14
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    I broke alot of bones in the past and I'm well past the age of healing quickly but, the only point I'll add to this good thread is try to resist the urge to do too much too quick it sets you back long term

  15. #15
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    I have spoken with my physical therapist about it, but unfortunately it doesn't seem to be available here in Europe.

    I guess that really the best thing to do is just to take it one step (or stretch) at a time and not to get to discouraged right away if things do not appear to improve.

    A good book on effective methods of stretching would certainly be welcome though at this moment. Do you know of one?

  16. #16
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    a couple of ideas for you

    Quote Originally Posted by BaconBrain
    I have spoken with my physical therapist about it, but unfortunately it doesn't seem to be available here in Europe.

    I guess that really the best thing to do is just to take it one step (or stretch) at a time and not to get to discouraged right away if things do not appear to improve.

    A good book on effective methods of stretching would certainly be welcome though at this moment. Do you know of one?
    First off, have you actually gone onto the JAS website? I deal with them on occasion and last time I believe Jeanie gave me her email address there:

    jcalhoun@jointactivesystems.com

    She just works there and has no PT advice to give you but can tell you or your doctor how to get the appropriate device, if that's even possible in Germany. They usually rent them to your insurance/doctor and they aren't cheap.

    Second, start another thread on Rider Down. Title it "Broken Elbow--Need advice" or something like that to attract the attention of others in your condition. I know now I should have titled this thread "Broken Wrist--Need Advice" but, whatever.

    Third, advice on how to stretch should be coming from your PT person and doctor. Don't ask me! Anything I learned how to do I got from them. Good luck.

  17. #17
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    Stupid Softball

    I broke the same bones, complete fracture of radius and ulna. Freaky looking near compound fracture. I was playing third base, ran after a pop fly in foul territory (sloping hill), caught ball, slipped down hill, karate chop backwards with softball in glove, and then the loud snapping sound of bones breaking.

    I had the surgery (no pins or screws fortunately), cast for 6 weeks, and lots of work on arm afterwards.

    Range of motion took a while to get back. I couldn't hold my hand out flat to receive change for a dollar.

    Good luck with the wrist. Keep working on it and it will improve.

  18. #18
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    how were you able to avoid pins?

    Quote Originally Posted by Bob_Element50
    I broke the same bones, complete fracture of radius and ulna. Freaky looking near compound fracture. I was playing third base, ran after a pop fly in foul territory (sloping hill), caught ball, slipped down hill, karate chop backwards with softball in glove, and then the loud snapping sound of bones breaking.

    I had the surgery (no pins or screws fortunately), cast for 6 weeks, and lots of work on arm afterwards.

    Range of motion took a while to get back. I couldn't hold my hand out flat to receive change for a dollar.

    Good luck with the wrist. Keep working on it and it will improve.
    I didn't hear any sounds of bones snapping, just felt the incredible force of my palm hitting the concrete. My injury mushed the end of the radius back and up, deforming the very end. The surgery pulled the end back down into position and the plate held it there till it "healed". The end of the ulna was also cracked but wasn't deformed. The doc said there were bits and pieces all over in there. I try not to think of that image too much! Hard to believe you had both bones snap and avoided pins.

    How long after surgery did you finally feel you could trust your hand/wrist like before? Or are you still working on that?

  19. #19
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    Good as New

    Quote Originally Posted by xcguy
    I didn't hear any sounds of bones snapping, just felt the incredible force of my palm hitting the concrete. My injury mushed the end of the radius back and up, deforming the very end. The surgery pulled the end back down into position and the plate held it there till it "healed". The end of the ulna was also cracked but wasn't deformed. The doc said there were bits and pieces all over in there. I try not to think of that image too much! Hard to believe you had both bones snap and avoided pins.

    How long after surgery did you finally feel you could trust your hand/wrist like before? Or are you still working on that?
    I had clean breaks without any pieces. I was also told that there was a 50/50 chance that I might need the screws and plates. I had to get xrays twice after the initial surgery to make sure the bones didn't shift. I got lucky!

    It took a while to trust the wrist again. Gradually, the ROM came back and the pain subsided. After a few months, I started weight lifting again and haven't had a problem since.

    The break happened nearly 19 years ago. Every once in a while when the weather conditions are just right (damp and cold), the wrist will ache a bit.

    Here's hoping for your speedy recovery. Good Luck...

  20. #20
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    Interesting thread

    I broke my radius at the distal end about 1" below the wrist on aug 6th. I got lucky in a sense in that it was only a partial break. It was a curving fracture that was heading from the thumb side towards the center of the articular surface, It stopped with less than a 1/4" of bone intact before it would have compromised the cartilage. I hit the ground at approx 20mph and was doing a shouler roll when my hand got stuck in a gopher hole...aside from the break I dislocated and messed up the tendons of both the thumb and the index finger
    Hurt like crazy. My wife drove us over to my firestation where I grabbed a sam splint an an ace bandage then it was off to the hospital an the orthopedic surgeon.

    I was fortunate in that I didn't need surgery for the bone but perhaps I should have had the tendons fixed. I was such a retard with my left hand, first time I tried to brush my teeth left handed the brush came out of my mouth and left a trail of toothpaste across my face
    I got the cast off in 5 weeks...man was the arm atrophied I had limited flextion at the wrist and no thumb strength what so ever. I went full blast into pt with light weights, massage, flexion exercises as we we coming into the height of fire season. I mae it through the season and a ropes rescue plus an auto extrication course using mostly my left hand.

    so after 6 months, 5 of which involved hard rehab I can finally sleep with out pain [first two months I screame every time I rolled over and the wrist flexed] the wrist is at 90% the thumb is at about 70% strenght an flexibility. I can do most of my favorite trails and I can just now ride my road bike with out the vibration causing extreme pain.

    If anyone is looking for a really good rehab facillity in the San Jose area I would highly recommend the More Clinic on the Alameda just north of 880. they are used by the sharks, 49er, raiders, stanford and sjsu plus most of the local PD's an Fire Depts. their focus is on getting perfomance athletes back into competition.

    work through the pain, keep at the rehab, stay positive and go for it
    Warning: Consumption of alcohol may make you think the person on the barstool next to you is attractive

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    Yo Buzz Cut

    Did your tendons heal themselves? I slept with my cast up on a pillow on my stomach (elevated) then with just my withered arm elevated for about 3 months. I can relate to the rolling over and screaming in pain. Fortunately I usually sleep on my back. I had some furniture delivered about two weeks after surgery and one of the guys carrying was a fireman who had broken his right wrist (like you and me) falling off a ladder. Seeing him a year after his injury hauling this heavy stuff (when at the time I couldn't even tie my shoes) was inspiring. I guess he had the night shift as a fireman and delivered furniture during the day, I don't know.

    My arm has built up again, although it's like it's "pumped" without any real strength like before. I still only curl 17.5 lbs (instead of 45), lat pulls on a machine with one 45 lb plate instead of two and a 25 each side, etc. Every time I think I'm ready to lift more I tell myself give it another month. I learned to write left handed and still do sometimes just to keep in practice. It's almost as legible as my right but a lot slower. I still brush my teeth left handed, still just naturally reach for things left handed, mouse at my computer left handed, whereas before my fall my left hand was nowhere near as coordinated as my right.
    Last edited by xcguy; 01-17-2007 at 08:07 AM.

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    naw the thumb is still not right but I can't afford to have it worked on right now, the strength is better but I still have pain and stiffness at max flexion. The improvement in my arm from months 5 to 6 has been remarkable. At month 5 I was wondering if I would ever heal an now I don't remember that I was hurt 99 % of the time. The only time I'm concious of the lingering injury is with heavy vibration or awkward loading of the wrist while carrying heavy gear
    Warning: Consumption of alcohol may make you think the person on the barstool next to you is attractive

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    Hm, I dented the tip of my radius a bit and my doctor installed this beauty!



    They call it an "external fixator". Really shook 'em up at the register when I reached for change. Not much fun when you bump into things tho. That was three years ago and I'm around 90% strength and flexibilty and can ride all day without thinking about it. There were some tiny pins under the skin to hold the small pieces in place but it all came out after six weeks, no hardware stayed in.

    -c

  24. #24
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    Elbow Injury and Recovery (long)

    This one's in response to BaconBrain:

    I want to take a moment to respond because I had similar questions about recovery and couldn't find much information anywhere. I have no medical training, and of course everyone's body is different, but this is my experience and the lessons I learned. I had a mtb accident over a year ago now and it turned out everything aligned just right to produce a really severe injury to my elbow. I fractured my radial head, broke a chunk of bone off my coronoid process, shattered the surface of my radial head (probaby the worst part) and did a bunch of ligament damage via elbow dislocation. After getting 2 incomplete diagnoses I got into an orthopedist, got a CT scan and discovered the severity of the injury. Surgery, 1 screw, several pins, barely dodged a plate. I was partially immobilized (half cast thing) for 2 weeks, and completely immobilized (full cast) for 2 more weeks. My range of motion out of surgery was pretty poor. Probably 30 or 40 degrees total motion flexion to extension and almost no mobility pronation/supination.

    I was very frustrated initially in PT. My mobility was not coming back at the rate I needed it to. I'd never been to physical therapy before and didn't really know what to expect. ONE key point is, not all physical therapists are created equal. My first one was bad. This injury needs a lot of hands on PT work. If you have the flexibility, switch PTs if you are not completely satisfied with the care you're being given. I switched once I began to realize the sub-par care I was receiving and wish I had switched even earlier.

    Before I go further into my case, I'll make a couple points. If you were injured in October, you're still within a period where you should be able to make some significant progress on your mobility. You're also far enough after the injury where you should be really aggressive with your stretching. Your PT should be pulling you off the table when yanking on your arm. If JAS is not available in Europe, try getting a Dyna-splint or similar device. I am SURE something like that is available in Europe. Don't take no for an answer. This is your health and it's time to be aggressive. As mentioned above, trying contacting JAS directly.

    I probably should have documented my progress myself, but roughly speaking, about 8 weeks out from surgery my mobility was somewhere around 45-50 degrees extension and 115 flexion. My pronation/supination was slightly improved, but still pretty bad. I got a JAS splint for extension/flexion and continued PT for around 3 more months. 2 or 3 months later I'd managed to get my extension around 5-10 degrees and flexion maybe 135-140. Pronation/supination was somewhere around 80-75 degrees or so. It got better a few degrees a week, and not always steadily.

    After the 5 month mark or so, I made some small improvement in mobility, but not a lot. I actually used a pronation/supination JAS device for several months after that.

    My advise is to do AS MUCH stretching as you can tolerate during the first 6 months as this is the most opportunistic time for regaining motion. I think I made the mistake early on of trying to do too much and getting too sore. Learn where your body's limit is and go to it as much as possible (however, I'd error on doing too much over too little) I probably put in at least 5 hours of focused stretching daily, and additionally would turn my wrist or stretch out my arm while doing other things throughout the day. I was told multiple times that the elbow is notorious for laying down lots of scar tissue and getting stiff. My doctor did not expect me to regain as much mobility as I did. Don't give up, and make sure you act such that you won't regret not doing more when you had the chance.

    Also, I encourage you to get support from friends, family, etc. I know my elbow is a far cry from what it used to be even though the mobility has come back reasonable well. I just did too much damage to the integrity of the joint. However, hopefully your injury is not as severe and/or your body recovers better and you may recover almost fully. Regardless, it can be a difficult thing to deal with, especially if you are a n extremely active person like myself and you depend a lot on your physical ability for your mental well being (or even employment), etc. For me, I've been a pretty careful guy, but made one bad decision that caused me to wreck, and had some bad luck regarding how I landed and the injury I incurred. It has not only been a struggle physically, but also mentally to forgive myself, to accept my injury, and move forward. A lot of people think a broken bone is just something you slap a cast on for a few weeks and then you're good to go. So reach out and get the support you need - I'm not saying you have to go crying in someone's arms, but a little empathy and some encouragement from someone can go a long way.

    Good luck, and if you have any questions don't hesitate to ask.

  25. #25
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    Jeesuz, dude

    Quote Originally Posted by chrisdabiker
    Hm, I dented the tip of my radius a bit and my doctor installed this beauty!



    They call it an "external fixator". Really shook 'em up at the register when I reached for change. Not much fun when you bump into things tho. That was three years ago and I'm around 90% strength and flexibilty and can ride all day without thinking about it. There were some tiny pins under the skin to hold the small pieces in place but it all came out after six weeks, no hardware stayed in.

    -c
    Yow! I didn't take any pictures of my hand when it was all swollen but your pic sure brings back memories! The plate I have in my wrist is really a new thing maybe in the past 5 years and that external fixator jobbie you had was standard proceedure back in the day. Glad you can ride all day without thinking about it. I'm a little more than five months from surgery and I think about going up and down stairs.

    What did they do under that scar on top?

  26. #26
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    The plate I have in my wrist is really a new thing maybe in the past 5 years and that external fixator jobbie you had was standard proceedure back in the day.
    Actually, for my injury this was the only solution. He described the tip of my radius as being "oatmeal" and the only way it was going to heal was to seperate it from my wrist bones. The fixator held the two bones apart allowing the radius to heal. The scar on top was where he went in and reassembled the bits and then skewered them with tiny pins to hold them in place. The pins were cut off short and the skin sewn closed over the top. After the six+ weeks, seems like it was closer to seven or eight, he used a knife to make a tiny slit and then pulled the pins out with pliers. The fixator pins simply unscrewed.

    This was my second bad bone breakage and I will agree with the advice you got to 1) Work on your flexibility every chance you get and 2) If you over exercise or over stretch you will take several steps backwards and could make the final outcome worse.

    -c

  27. #27
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    Interesting info from your post

    Quote Originally Posted by chrisdabiker
    Actually, for my injury this was the only solution. He described the tip of my radius as being "oatmeal" and the only way it was going to heal was to seperate it from my wrist bones. The fixator held the two bones apart allowing the radius to heal. The scar on top was where he went in and reassembled the bits and then skewered them with tiny pins to hold them in place. The pins were cut off short and the skin sewn closed over the top. After the six+ weeks, seems like it was closer to seven or eight, he used a knife to make a tiny slit and then pulled the pins out with pliers. The fixator pins simply unscrewed.

    This was my second bad bone breakage and I will agree with the advice you got to 1) Work on your flexibility every chance you get and 2) If you over exercise or over stretch you will take several steps backwards and could make the final outcome worse.

    -c
    The way they explained my injury was sort of like yours but maybe more displaced: the end of the radius was pushed back AND up and was basically mush. They tried to "reduce" it (push it back into place) which is my new standard for pain even though I was highly drugged up at the time. Even though it went close to back into place they recommended the plate to hold it in place while it healed. I can see your fixator would appear to separate the wrist bones from the radius (as you've described). The pins that your doc put in there (and later removed) were duplicated by the pins in the plate I got. My doc said the bits and pieces were gathered up by my plate's pins and slowly brought back into place during surgery.

    What wasn't explained to me when they put my cast on (and was never brought up by me or anyone else) was the angle that my wrist was casted. In your pic I see your hand being held by the fixator at a down angle (and, yeah, pulled away from the radius). They bent my hand way down then the hard cast held it there for 4 weeks. When they took off the cast bending my hand backwards was impossible, but the JAS device and constant tugging twisting stretching has got that motion back pretty well, but not at all like my other wrist. I was always wondering why the heck they bent my hand way over and now I can understand, from your description. As I mentally peer down into my wrist I can see how scar tissue probably formed (my PT lady calls it "hard fill") in the spaces between the radius and the wrist bones and I'm now trying to break down this hf with my stretching.

    How successful I'll be regaining range of motion in all directions remains to be seen. I still work on all directions all the time (still under 6 months) but I need to reign in my desire in the gym to lift heavier. As I reach for a heavier dumbbell I say am I ready for this? then reach for the next lightest one.

    Forgive me for pointing this out but I used to shoot a lot of hoops, free throws 3 pointers etc and was pretty accurate. When I first put a basketball in my right hand about 5 weeks ago I couldn't even throw the ball up past the rim. Then a week later I could get it into the basket from 2 feet away. A week later from 5 feet away. Finally, 2 weeks ago I made my first free throw since July. Yesterday I made a three pointer, a heave that seemed impossible even two weeks ago. So, progress on the basketball front is always welcome. Now if the snow here in Colorado would just go away I'll see my how my handlebar feels on some gnarly rocky downhill.

  28. #28
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    I'm pretty happy with my range of motion bending the hand forward and backward. When the device first came off I was shocked to find my hand could not bend back - at all! It could bend down maybe 5 degrees but not up. It even made a "thump" sound when it reached the upward limit.The thing I still work on now is getting my palm to face straight up. Before the injury I never even thought about how a wrist works - there are two bones going in, when you turn your hand from palm down to palm up these two bones must essentially spin in relation to each other as they switch places.. Well, with all the scarring in there I no longer had the clearance for this. And if you try to force it, you're basically prying the two bones apart which is not going to do your healing ligaments any good at all. So I'm still working on it and getting better all the time. The first six months are important, sure, but that doesn't mean you should just give up after that.

    -c

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    palm turning up

    Quote Originally Posted by chrisdabiker
    I'm pretty happy with my range of motion bending the hand forward and backward. When the device first came off I was shocked to find my hand could not bend back - at all! It could bend down maybe 5 degrees but not up. It even made a "thump" sound when it reached the upward limit.The thing I still work on now is getting my palm to face straight up. Before the injury I never even thought about how a wrist works - there are two bones going in, when you turn your hand from palm down to palm up these two bones must essentially spin in relation to each other as they switch places.. Well, with all the scarring in there I no longer had the clearance for this. And if you try to force it, you're basically prying the two bones apart which is not going to do your healing ligaments any good at all. So I'm still working on it and getting better all the time. The first six months are important, sure, but that doesn't mean you should just give up after that.

    -c
    Yeah, we all take our parts for granted and give it no thought how they actually work 'til something goes horribly wrong. From what my pt lady said there's three points of rotation that can lock up (simplifying here). One is at the end of the ulna, which I fractured as well. Working on turning my palm either up or down, it seemed the sticking point was the right side of my wrist. I would hold a hammer and let the weight pull on the rotation both directions. But since the wrist would stop rotating I thought maybe the pain is telling me that's all there is at the end of the ulna but the other rotating points aren't getting worked on.

    So...she had me close my right fist, turn the right wrist as far palmupward as it would go, grab my right wrist with my left hand (palm down) and gently twist the lower right forearm towards the right palm up direction. I did that for weeks. Well, that's what did it. This stopped me putting so much pressure on the painful ulna and worked the rotation of the two forearm bones like you described as well as the rotational area at the elbow.

    I'm typing this one-handed because I have my JAS device on, but until I could turn my right palm down (worked on that direction in the same fashion) I typed one-handed with only my right pinky assisting.

    So I'm pleased with my palm rotation but still need to get my hand to bend backwards more. I'm not particularly looking forward to going OTB and landing on my palms!

  30. #30
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    I broke my distal radius a few years back - landed arms outstretched going OTB. Thought it was just a bad sprain at first. Rode 1.5 miles (downhill pavement) back to the truck, took some Advil and used a first-aid-kit type ice pack on it.

    I still thought it was probably a sprain when I met my wife for lunch but during lunch it started throbbing and really started to hurt so we went to the ER. Good thing we ate first. It took over 3 hours of waiting to be seen and x-rayed.

    Anyway, I had split it like a log - not quite mush as CDB described his but, yeah...like a log...split with a full-on hydraulic log splitter.

    Found my ortho through my insurance and got a second opinion. Both said I'd need plates and pins to fix it and it was speculated that I would need an external as well.

    Ended up with 3 incisions, 3 plates, too many pins and screws to count and somewhere in there had managed to damage the tendon that pulls the tip of my right index finger. The surgery caused me the absolute most excruciating pain I have felt in my entire life. When I came to hours later in my hospital room, the general anesthesia had worn off and I was on a morphine drip.

    Only problem is that morphine doesn't work for me - something that I found out only then because I'd never broken anything seriously up until that point. Morphine makes me nauseous and did nothing for the pain, so now I was in horrible pain AND vomiting uncontrollably. It took hours for my doc to show up and force the floor docs and nurses to take me off of the morphine and give me good old perkaset.

    Anyway, that was just the first surgery. The tendon fully ruptured later and the doc attempted to hook it back up in surgery #2 where he also removed 2 of the 3 plates. The tendon ruptured a 2nd time and surgery #3 was required to finally hook it to the tendon that pulls my middle finger. It was a long time before I didn't have to think about what I was doing for fear of accidentally burning or stabbing the tip of my finger.

    Throughout it all, I was in and out of casts and in and out of PT. I got most of my motion back and even for insurance, it still cost a fair amount for all of the uncovered incidentals. I have alot of tissue scarring inside my wrist and hand and I can feel the knots of scar when I massage my palm.

    Falling always sucks. I'm always afraid when I fall that I'm going to break it again or at minimum compress the scar tissue in sensitive places.

    Try to get gloves with thick padded palms and some sort of wrist support - modified roller blade guards or the like. I go back and forth about how much protection I wear in regard to where I ride.

    A mostly fireroad route will get the padded glove tratment only, technical terrain and/or rocky terrain usually gets both heavy glove and wrist guard.

    One side note about the wrist guards is that my wrists don't get as tired on long technical rides.
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  31. #31
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    What a story

    Quote Originally Posted by Dan'ger
    I broke my distal radius a few years back - landed arms outstretched going OTB. Thought it was just a bad sprain at first. Rode 1.5 miles (downhill pavement) back to the truck, took some Advil and used a first-aid-kit type ice pack on it.

    I still thought it was probably a sprain when I met my wife for lunch but during lunch it started throbbing and really started to hurt so we went to the ER. Good thing we ate first. It took over 3 hours of waiting to be seen and x-rayed.

    Anyway, I had split it like a log - not quite mush as CDB described his but, yeah...like a log...split with a full-on hydraulic log splitter.

    Found my ortho through my insurance and got a second opinion. Both said I'd need plates and pins to fix it and it was speculated that I would need an external as well.

    Ended up with 3 incisions, 3 plates, too many pins and screws to count and somewhere in there had managed to damage the tendon that pulls the tip of my right index finger. The surgery caused me the absolute most excruciating pain I have felt in my entire life. When I came to hours later in my hospital room, the general anesthesia had worn off and I was on a morphine drip.

    Only problem is that morphine doesn't work for me - something that I found out only then because I'd never broken anything seriously up until that point. Morphine makes me nauseous and did nothing for the pain, so now I was in horrible pain AND vomiting uncontrollably. It took hours for my doc to show up and force the floor docs and nurses to take me off of the morphine and give me good old perkaset.

    Anyway, that was just the first surgery. The tendon fully ruptured later and the doc attempted to hook it back up in surgery #2 where he also removed 2 of the 3 plates. The tendon ruptured a 2nd time and surgery #3 was required to finally hook it to the tendon that pulls my middle finger. It was a long time before I didn't have to think about what I was doing for fear of accidentally burning or stabbing the tip of my finger.

    Throughout it all, I was in and out of casts and in and out of PT. I got most of my motion back and even for insurance, it still cost a fair amount for all of the uncovered incidentals. I have alot of tissue scarring inside my wrist and hand and I can feel the knots of scar when I massage my palm.

    Falling always sucks. I'm always afraid when I fall that I'm going to break it again or at minimum compress the scar tissue in sensitive places.

    Try to get gloves with thick padded palms and some sort of wrist support - modified roller blade guards or the like. I go back and forth about how much protection I wear in regard to where I ride.

    A mostly fireroad route will get the padded glove tratment only, technical terrain and/or rocky terrain usually gets both heavy glove and wrist guard.

    One side note about the wrist guards is that my wrists don't get as tired on long technical rides.

    Yikes, multiple surgries AND complications! Thanks for the tip about the wrist guards. I'm actually kind of terrified of my first OTB this spring when I finally start riding again. My doc points to my wrist and says that if I were to break something down there she points above and below my plate and says, what's plated ain't moving. Somehow that makes me feel better but hard to say how much.

    When I had my only surgery I was given these options (of course, I'm laying on a hospital bed all freaked out about surgery anyway and signing form after form with my left hand): local anesthesia and be awake (NOT recommended they said): local anesthesia with a nerve block and be awake (better but why would I want to be awake, they asked?): and finally, local anesthesia, nerve block and be totally out (recommended by all). I was scared as sh!t about going under the knife anyway and being totally out isn't necessarily a given that you'll come back out. Decisions decisions. OK, all three. They switched the saline drip going in my left arm to some knockout drug (I didn't see them do the switch), the anesthesiologist was searching around my right shoulder for the proper place to stick his nerve block needle (because the bone was being worked on this would knock out that specific pain area for another 24 hours after surgery). I'm looking at him saying something
    like "is that the spot" when...I'm waking up from surgery. I look at the lady doc leaning over me and I say "already?" She smiles sweetly and I fell in love with her, but maybe that's always the reaction when you come out of surgery alive and your attending is as good looking as she was.

    Fortunately I didn't have to go through the unbelievable back and forth that you did with all the pain and morphine and multiple surgeries. Max dose of Vicodin for 6 weeks was my drug regimen and I never was in huge pain (not like before the surgery). I'm guessing you weren't out for the surgery? How are things at your distal end now? And give us a little more info about those wrist guards--are there different types for different protection, do they interfere with the whole hand/handlebar/shifting thing?

  32. #32
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    Quote Originally Posted by xcguy
    Yikes, multiple surgries AND complications! Thanks for the tip about the wrist guards. I'm actually kind of terrified of my first OTB this spring when I finally start riding again. My doc points to my wrist and says that if I were to break something down there she points above and below my plate and says, what's plated ain't moving. Somehow that makes me feel better but hard to say how much.

    When I had my only surgery I was given these options (of course, I'm laying on a hospital bed all freaked out about surgery anyway and signing form after form with my left hand): local anesthesia and be awake (NOT recommended they said): local anesthesia with a nerve block and be awake (better but why would I want to be awake, they asked?): and finally, local anesthesia, nerve block and be totally out (recommended by all). I was scared as sh!t about going under the knife anyway and being totally out isn't necessarily a given that you'll come back out. Decisions decisions. OK, all three. They switched the saline drip going in my left arm to some knockout drug (I didn't see them do the switch), the anesthesiologist was searching around my right shoulder for the proper place to stick his nerve block needle (because the bone was being worked on this would knock out that specific pain area for another 24 hours after surgery). I'm looking at him saying something
    like "is that the spot" when...I'm waking up from surgery. I look at the lady doc leaning over me and I say "already?" She smiles sweetly and I fell in love with her, but maybe that's always the reaction when you come out of surgery alive and your attending is as good looking as she was.

    Fortunately I didn't have to go through the unbelievable back and forth that you did with all the pain and morphine and multiple surgeries. Max dose of Vicodin for 6 weeks was my drug regimen and I never was in huge pain (not like before the surgery). I'm guessing you weren't out for the surgery? How are things at your distal end now? And give us a little more info about those wrist guards--are there different types for different protection, do they interfere with the whole hand/handlebar/shifting thing?
    As far as I remember, I wasn't offered a nerve block. That could be why I was in such excrutiating pain. When I broke my collarbone 2 years ago, I was offered a nerve block for that surgery and felt much better during the recovery time.

    However, the difference between the 2 is that the pain I felt while my collarbone was broken (before surgery) was like huge electrical shocks every time the bone fragments shifted and rubbed against each other and into the nearby tissue. After the surgery, the parts were all held in place by a huge rod that also straightened out all of the other mechanics of my shoulder.

    Back to wrists:

    I don't remember what the nurses looked like; whether they were angels or devils. I just remember the pain and being groggy and sick. I was probably slurring my words or something but I couldn't get anyone to help me and it seemed like forever before I had pain relief.

    What the doc told you about the plates may be somewhat true. The bone under the plates will be made up of new, dense bone. However, the screws and pins holding the plates can come loose and when they back out can cause damage to tissue, muscle, etc. Even as far as poking through the skin from the inside. I had a couple that did that and were removed in surgery #2.

    I recommend that if you can have them removed that you do so. I'm no doctor but my experience (and what I've heard from riding friends) shows that handlebar vibration can cause pins and screws to loosen. I had the rod from my shoulder removed, too.

    Everybody makes different wrist guards. Fox makes gloves with wrist wraps - I haven't tried them yet but they don't seem to have the padded/armored palm like the gloves I usually wear. Every sports shop has rollerblade wrist guards. I found a pair that the plastic supports were removable but the shell was still durable enough to provide some protection and support without getting in the way of shifting and braking. I went through 3 pairs before I found them.

    They do stretch the glove farly tight so I went with a size up on the gloves. That also works when I want to wear my neoprene gloves underneath for wet/cold weather riding. The neoprene gloves I have don't have any palm armoring but have plenty of warmth. Obviously, I don't wear all 3 together.
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  33. #33
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    Non-removable pins here

    Mine is a plate that has a set of screws attached to it that attach to the radius along the length of the plate and a bunch of them at the distal end that when rotated pulled everything back into shape (so they tell me). I asked them about the screws pulling out but was told again and again that the bone has solidified around the pins and it's basically one structure now. Time will tell. And it's in there forever.

    One lesson here is when I'm offered a nerve block again I'll just say yes. So many decisions just a few moments before surgery, but the anesth. guy was very insistent that I get the nerve block and I guess you now wish you had been offered it. The pain I had when they were trying to "reduce" the end of the radius two days before surgery was unbelievable--if that's what you were going through there's no words to describe it. As far as your misery after surgery, that really sucks but that wasn't my experience. Mine was positive from start till my buddy was guiding me outside the hospital that night. And the attending who was smiling at me almost felt like I was in an episode of "Scrubs" and it was Elliot who was taking care of me. I'll be sure to ask for her next time I'm in there.

    I'm going to start my search for the perfect wrist brace today. I'm not going to be needing it for at least a month (it's snowing as I write this--seventh weekend in a row, but that's another thread) so I'm going to hit all sports stores to find one that works as well as the one you're using. Thanks for the advice.

  34. #34
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    My broken wrist in the seventh month

    after surgery. I've been hitting the weights heavier and heavier (although about 1/2 where I was before I fell). It's so liberating feeling myself become strong again. I bought a wrist brace
    but haven't ridden with it because I feel so non-paranoid without it. The key fact here is that I CAN ride. I never was that ballsy a rider, you know, DHing like a sumb!tch, but I just didn't know how I'd feel mentally when back on the bike. Trails have cleared up enough here on the Front Range of Colorado (although it's snowing as I type this) so that I can get out and test my wrist. I'm surprised I'm not more scared of crashing but I didn't break my wrist on a bike, anyway, it was falling off a freakin' ladder. I sure don't want to go OTB, though.

    I'm going to Moab middle of March and we'll see about paranoia and pain then, but I am so grateful that I can even plan a trip like this (a twice-a-year trip for the past 10 years). I'm using my right hand normally, even though the strength isn't all back. I have to remember to tell guys who I'm gonna shake hands with "don't squeeze!". If I don't, most dudes want to crush my hand in some macho handshake and that really hurts! Otherwise I can do all the things I used to do (like opening cans in the kitchen) so my life is more or less back to normal. I still do PT to stretch my hand backwards but, considering the nature of my break, it's doubtful that's gonna come back. Hope it does, but no progress in that direction in the past two months. I can use my right hand to receive change in a store and type on this here keyboard normally, although I tend to mouse with my left hand to keep the fatigue at bay. Using my left hand a lot is something new but, hey, whatever works.

    Anyway, this is my first real big breaking of a body part and it's been a learning experience. I wish it hadn't happened but I'm satisfied with the progress I've made. Sheeit, I could have hit my head when I fell and still been in a hospital bed drooling with a closed head injury--but I'm coherently typing this post and planning on Moab. Life is good.
    Last edited by xcguy; 03-05-2007 at 11:27 AM.

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    Back from Moab

    It's kind of weird posting now that I'm through my dark hours and leading a fairly normal life, but I'm doing this for my fellow riders out there who are just entering the recovery phase and wonder WTF can I look forward to?

    I went to Moab thinking I'll take it easy and see what comes. I played the wuss and walked a lot of sections I've always ridden but my wrist/hand never hurt me so much that I had to call a ride short and head back. Even now as I type this my hand doesn't hurt. It still doesn't bend backwards like before but at least I know, now after about 8 months after surgery, that I can ride fairly pain free. Keep optimistic, those of you who are currently f!cked up--it'll get better with time.

  36. #36
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    ...

    It is nice to see some positive experiences from a wrist injury. I did mine almost two weeks ago. Galieazz fracture. Broken radius and dislocated distal radial ulnar joint (wrist). Surgery, plates, screws, and pins to stabilize my joint. I got my above the elbow splint off yesterday and am working on getting my flexion/extension back in my elbow. Pins come out in 5 weeks - then rehab begins. I am in a cast from my elbow down right now; so no wrist movement at all. I am concerned, but hope that I will come back 100%. Three years ago I tore my ACL, LCL and meniscus and came back from that just fine. Doc says that he would rather have my wrist injury over an ACL anyday, but I am not so sure just yet. Right now I feel like I will never come back the way I was. I have the bar exam in about 3 and a half months. Will I be typing with both hands by then? Thanks in advance for the replies and encouragement...

  37. #37
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    Hang in there

    Quote Originally Posted by drboudreaux
    It is nice to see some positive experiences from a wrist injury. I did mine almost two weeks ago. Galieazz fracture. Broken radius and dislocated distal radial ulnar joint (wrist). Surgery, plates, screws, and pins to stabilize my joint. I got my above the elbow splint off yesterday and am working on getting my flexion/extension back in my elbow. Pins come out in 5 weeks - then rehab begins. I am in a cast from my elbow down right now; so no wrist movement at all. I am concerned, but hope that I will come back 100%. Three years ago I tore my ACL, LCL and meniscus and came back from that just fine. Doc says that he would rather have my wrist injury over an ACL anyday, but I am not so sure just yet. Right now I feel like I will never come back the way I was. I have the bar exam in about 3 and a half months. Will I be typing with both hands by then? Thanks in advance for the replies and encouragement...
    During my dark hours just after my injury I was full of all the doubts you're going through. But your injury is not my injury or anybody else's so I can only speak for me. I never had an above-the-elbow cast but I did have to work a lot on my hand turning palm down palm up, and it finally came back 99%. Once you get your cast off you'll be weak as heck, stiffer than a board and wonder WTF is going to happen. Well, after the swelling goes down and the pain subsides you'll be able to start teaching your hand to be a hand again. I believe you will be typing in 3 1/2 months but you have to be able to turn your hand palm down so work on that a lot. That was very important to me.

    I just got back from Moab again and the wrist didn't hurt me this time either. I'd bought a wrist brace but never wore it. I'm able to work on my strength in the gym more and more without fear of re-injury so that's a relief. I'm in my eighth month after surgery and very pleased with my recovery.

  38. #38
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    Quote Originally Posted by stripes
    Which fox gloves with added wrist protection do you recommend?
    Yeah, im curious too. I read that the EVS wrist brace is pretty good, would anyone recommend that?

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    Quote Originally Posted by stripes
    Which fox gloves with added wrist protection do you recommend?
    This was the pr I was referring to although I have no knowledge of fit or how well they work:

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  40. #40
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    Gloves to protect your wrist

    I researched getting a wrist brace to wear while recuperating, but I found varying opinions, mostly: if you wear a brace on any part of your body, the stress of a crash is displaced to some other part. As my pt lady said (as she pointed to about a 6" section of my wrist) if I was in a car crash my bones would break "here and there but not (where I now have my metal)". A ski instructor said on some other forum that he always recommends wrapping the recovering part with an elastic bandage to help support it but not to absolutely isolate it from the stresses of a crash, which you'd do with a full-on brace. Since I didn't incur my injury on a bike I didn't have the paranoia of falling (from a bike crash) again, but sure I was more cautious. And I still am. About those gloves in the picture--I have no opinion, sorry. I never wore the wrist braces I bought nor did I wrap the area. I just rode real slow.
    So it seems to me to be, this thing that I think I see.

  41. #41
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    A couple more thoughts

    Quote Originally Posted by stripes
    Thanks. I'll keep that in mind about the braces. Maybe wraps are a better idea.. Here's the latest news.

    The good news is there is minimal bruising and the doctor was quite surprised at how much the swelling has gone down. I've been walking the track in the evenings, and I completely changed my diet.

    Surgery is confirmed for Thursday. The doctor's not sure he's going to use an external fixator now after all. The two possibilities are:

    1) if there's enough bone in the fragments to hold the screws securely, they'll piece everything together and then cast the arm up to the elbow
    2) if there's not enough bone to hold the screws properly and there's a risk of slippage, he'll supplement the screws with the external fixator and a splint

    Both have pros and cons. The cast is less maintenance but (as those who have had casts can attest to) the smell and the itching can be a bit of a hassle. The external fixator supposedly heals as fast or faster than the cast but has to be cleaned properly twice a day to prevent infection.

    The surgery is scheduled to be ~2.5 hours. The worst part is that I can't eat or drink anything (not even water) for 10 hours prior to the surgery. For those of you who have seen me skip a meal, you'll understand why this is the part that concerns my husband most.

    I'm going to be on pain-killers and anti-inflammatories for most of the weekend.

    Wish me luck..
    I was cast only up to my elbow and thank god for that because at least mentally I knew I was keeping my range of motion through my elbow. The cast didn't itch as bad as I thought it would (had to put a plastic bag over it with a rubber band to close the end of it while showering). Just before surgery the anesthesiologist asked me what kinds of drugs I wanted and mentioned the nerve block. Since they were going to affix that little chunk of metal to the bone he strongly advised it and I've heard from others who either weren't offered the nerve block or refused--well, they wish they'd had one. As it is the nerve block specifically knocked out the pain at the bone for another 24 hours after surgery and that was a good thing. The not eating was not as bothersome as the not drinking at all (it was 97 degrees the day of my surgery and it wasn't till 5 pm). They gave me a saline drip at pre-op which helped a lot. Of course, they switched the drip to the knock-out drug while I wasn't looking--and I woke up in post-op, just like that! I was on Vicodin for a month after surgery (I guess more than a month) so being medicated probably helped my state of mind. Just re-read this entire thread for other answers to your questions or just ask here again. Good luck and remember--as you enter the hospital--just let go. And practice your signature with your good hand now because you're going to be signing a few documents in pre-op.
    So it seems to me to be, this thing that I think I see.

  42. #42
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    I just re-read this thread

    My wrist break was last August and now it's 13 months later. I'd put out of my mind how inconvenient being injured and one-handed was. I now do all the things I used to do (except my basketball skills suck--it's like shooting hoops with someone else's hand), I ride pain-free. I never wore a wrist brace. I lifted very lightly at first (starting at maybe 5 months after surgery) and finally started lifting heavier about a month ago, going for strength and bulk. The wrist is painful but just enough to remind me of the damage that occurred in there.

    I can bend my hand down about 95% of my left, but backwards it's only about 75%, but that's enough to do everything like before. Haven't tested it going OTB, though. I say to myself all the time--Make a fist make a fist--when I do eventually go OTB. The tingling I had in my fingers went away completely. I CAN make a fist (that took a long time to stretch the fingers out--both directions). All in all I'd say I've "completely" recovered but I sure do wish it'd never have happened.

    On my sisters advice I started watching "Scrubs" the first week after surgery. Even though I laugh all the time at the humor, "Scrubs" has some poignant moments that I could really appreciate--I guess you'd have to be injured and been through surgery to see that side. Anyway, I just watched the Scrubs musical a few days ago and I have to say I got all choked up when the lady who heard singing was just about to go into surgery. She's saying "what's going to happen? Am I going to be OK?" and the nurses and doctors are singing "you're going to be OK" Then BLAM she wakes up from surgery and she's OK.
    Well, folks, that was EXACTLY how it was for me (minus the singing). It was so real seeing it in Scrubs, so close to my experience.
    So it seems to me to be, this thing that I think I see.

  43. #43
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    Quote Originally Posted by xcguy
    She's saying "what's going to happen? Am I going to be OK?" and the nurses and doctors are singing "you're going to be OK" Then BLAM she wakes up from surgery and she's OK.
    Well, folks, that was EXACTLY how it was for me (minus the singing). It was so real seeing it in Scrubs, so close to my experience.
    LOL! Thank goodness for anesthesia That really is how it happens if you're lucky enough to get a good anesthesiologist and don't have a bad reaction. Otherwise....

    I recall yapping away at the folks in the OR. I couldn't shut up. Then I noticed they were all standing there, arms crossed, staring at me and looking bored. The light went on in my head "Ohhh... you're all waiting for me to fall asleep!" The doc says "Your arm will feel a little warm." Another couple minutes, more funny/smart-assed remarks from me and I see they're still standing with crossed arms. "It's gonna feel warm again, isn't it?" That one did it. Before I could say goodnight I was out like a light. Woke up suddenly two hours later with no pain, no recollection of what they did to my once slender and fully functional wrist and not a care in the world. Unfortunately all the good stuff wore off about 8 hours later.

    I get to have the screws removed in a few days. How bad do y'all think this will hurt? Is it a quick process, or a slow grind? We're going outpatient with no sleep, so I need to know if I should just bring some bullets to bite on or ask for the really good oral pain meds.

  44. #44
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    I used a JAS device

    Quote Originally Posted by stripes
    How long before you got back the majority of your ROM forward and back? It's taking me forever to get the backwards motion.
    which statically locked my wrist backwards for a few minutes, then I dialed it more pressure, waited five minutes, dialed it more...this went on for months. You know about these, don't you stripes? A lot of docs/pt folks don't, mine did. I got what was possible, which isn't like before, but, hey, I'm happy with it. It started a few weeks out of my cast. Four months doing the Jas thingy, three times a day for a 1/2 hour each time...the last month I was hoping for more but that was it. I'll post pics of the comparison between my left (good) and right (compromised) later. I can't imagine getting what I did back without it. I always had 90% of my forward movement (even though I did sometimes do the JAS device in that direction) thank gawd, because that would have been a total of 3 hours daily for each direction for four months if I'd had to work both directions equally.

    The first six months is when you have to work on it hard. Good luck.
    So it seems to me to be, this thing that I think I see.

  45. #45
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    OK, the pics I promised...hope this doesn't worry you

    Uninjured left wrist. That's all the backwards motion I have normally.

    "Healed" right wrist. I'm glad to have this much backwards movement. This was what I got after 5 months of working real hard on it with the JAS device and pushing it back while stopped at lights while driving.

    Check how your good wrist moves when your hand is going backwards. Right above your wrist, on the topside of your hand, is where there's a bunch of bones that sort of articulate over themselves at the very fullest of bending it back. Well, all those bones got blocked with "hard fill" and when I push my right hand backwards it just stops CLUNK! and that's all there is. The left wrist wants to bend farther and doesn't just come to a dead stop.

    Three weeks before I fell off that freakin' ladder (my fault, I know, should had it placed steadier) I went OTB so suddenly I left my shoes behind, in a nanosecond I was vaulting off my outstretched hands, did a somersault off the trail next to a bunch of cactus. I vividly remember landing on my outstretched hands before vaulting into that somersault. I also cringe when I think of doing the same move now. I ride real slow these days.
    Last edited by xcguy; 06-20-2012 at 05:14 AM.
    So it seems to me to be, this thing that I think I see.

  46. #46
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    Here's xrays of the device they attached to my radius

    This was put in two days after my accident. It's over a year later and I don't even know it's in there. I thought I'd set off airport alarms (I take a pic with me to show them) but that hasn't happened.
    Last edited by xcguy; 06-20-2012 at 05:13 AM.
    So it seems to me to be, this thing that I think I see.

  47. #47
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    I'm bumping this thread up so it doesn't get lost on some back page

    I just reread this thread and it all came back to me, the injury, the surgery and my recovery. It's now about 1 1/2 years after my accident. A guy told me he couldn't trust his hand for about a year and half and I know what he was talking about. Only in the last few months can I lift in the gym without thinking about my right wrist. My basketball shooting is a whole lot better but I always did suck. I reach for things with my right hand now, but I do have a mouse on either side of my keyboard and mostly mouse with my left.

    I haven't said "don't squeeze" to guys wanting to crush my hand in a handshake (that's been for about the last three months). My hand doesn't hurt me riding, neither climbing nor descending. I guess you could say I'm fully recovered except I can't bend my hand back nearly as much as before but that's just the way it is. Overall I'm pretty happy.

    I thought my right hand would get colder than my left during the winter but that didn't happen. The disconcerting tingling I had in my fingers went away. I thought I would notice the metal in my wrist somehow but I don't. Unless I lean the underside of my wrist on something and the tendons rub against the metal, now that hurts. When I ride I don't think of my wrist at all, although my paranoia of going OTB remains. Life goes on.
    So it seems to me to be, this thing that I think I see.

  48. #48
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    xcguy, did it come back to 100% after all this time? My surgery was on 1/25, about 65% percent now, and the JAS is being ordered. Of course, my wrist is also hypermobile.

  49. #49
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    Quote Originally Posted by stripes
    I still mouse left-handed, but it's mostly to annoy my cow-orkers

    Seriously, I still mouse left-handed because I'm an engineer and my live my life by the keyboard.

    Do I trust my wrist? No, not yet. Does it hurt? Not nearly as much since I have the Thumbs of Death (my chiro) break down the scar tissue. ROM isn't as great I'd hope, but I think that's due to the exceessive scar tissue so I'll be working on it soon.

    I'm starting to use my bike wrenches with my right hand again, which is MAJOR progress for me. My dexerity isn't great, but it's getting better. My handwriting is bad, but it was bad before the accident.

    Weight training isn't too bad. I think I'm being too conservative with my wrist, but I'm comfortable picking up 40 lb plates at the gym again.

    I was able to ride 20 miles on Friday!! Not only was I able to pace myself (finally), but I was able to ride without any wrist pain. Still also afraid of OTBing.. more likely to fall sideways.
    I just passed the 5 year mark from having broken my wrist. I have 80% of my mobility back without having used a JAS device. I still have a lot of scar tissue in my carpal area and touch sensitivity at my incision scars.

    I used my mouse left-handed until a few months ago. Going back and forth between my wife's desktop, my laptop and my work desktop got to be frustrating so I finally switched it back.

    One of the other side-effects of the surgery and my complications is that my right thumb tires quickly and the SRAM thumb shifters especially would cause me pain on long rides when my thumb fatigues. I switched to Shimano finger/thumb shifters but eventually changed to the Shimano integrated brake/shifter lever combos. I have a Saint set on my Nomad and LX on my hardtail. They work great and I have no strain on my thumb.

    I have stopped using the wrist brace. It was never constrictive enough to have caused a potential injury to transmit to another part of the body but absorbed blows and spread the force along the length. I still consider the use to have been helpful - like wearing knee pads or elbow guards on technical trails to absorb the blow that would otherwise cause injury to the impacted area.

    I also don't worry as much. My riding has improved, as it would for anyone over a 5-year period, and so has my confidence. I know that if I'm riding a new piece of equipment or new tires or new trails, I take it down a notch but otherwise, I just ride hard and feel good about it.
    There are no stupid questions but there are A LOT of inquisitive idiots.


    Bicycle Trails Council of the East Bay

  50. #50
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    So I am on the front end of this ordeal

    Went OTB about 6 six weeks ago on a short Sunday ride. 25+ mph on a downhill, too much air and not enough runout before the curve. Stopped myself with my left hand and... my face. Old enough (and enough riding experience) to know better, but 1/2 a second of thinking you are 21 instead of 41 is a bad thing.

    Crushed the end of my radius, smacked the bridge of my nose into a rock, which drove my sunglasses into my face. Broke my nose, profuse bleeding, man it hurt. My first though was, did I crush my face. Second thought was, my wife is going to be really p!ssed.

    Bystanders called 911 and my wife; EMS came and put a splint on me, made sure I was stable, and my wife drove me to ER. Got 13 stitches in my face in 4 spots, and a temp splint. Went to the ortho the next day, and he tried to set it (photos attached). No luck, so 5 weeks ago tomorrow, I had almost the exact same plate as xcguy put in my arm (x-ray looks almost identical)



    So I go tomorrow to get my PT orders; really glad I found this thread and the info on JAS gear; I will ask the ortho about it tomorrow.

    The ironic part of the whole ordeal is that I had ordered a new frame to build up right before the accident- it arrived the Wednesday after I went OTB. Been slowly collecting the stuff to build it up ever since; looks like it will be ready quite a while before me.
    Attached Images Attached Images
    Last edited by Mr Bacon Jr; 04-07-2008 at 08:54 PM.

  51. #51
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    I don't know what you mean by hypermobile

    Quote Originally Posted by onetimer42
    xcguy, did it come back to 100% after all this time? My surgery was on 1/25, about 65% percent now, and the JAS is being ordered. Of course, my wrist is also hypermobile.
    But no, I'm not 100% but I've adapted, like no pushups because my hand won't bend back enough to put it flat on the floor. Use that JAS device at least two times a day if not three times. You've only got the first six months to get what you're going to get. Don't be walking around the house when you've got it on. I found my coordination took awhile to come back and I kept falling (and I never fall as a rule, something about having the JAS device on my right arm!).

    And one thing I've learned from this thread (and other broken wrist peep threads) is everyone's "broken wrist" is different. I even heard from one person who was playing the piano a month after surgery. I was just able to open a refrigerator door 2 1/2 months after I got my cast off. I'm back in the gym curling 45 lb dumbbells but it's been a year and a half.
    So it seems to me to be, this thing that I think I see.

  52. #52
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    Nice face dood!

    [QUOTE=Mr Bacon Jr]Went OTB about 6 six weeks ago on a short Sunday ride. 25+ mph on a downhill, too much air and not enough runout before the curve. Stopped myself with my left hand and... my face. Old enough (and enough riding experience) to know better, but 1/2 a second of thinking you are 21 instead of 41 is a bad thing.

    Crushed the end of my radius, smacked the bridge of my nose into a rock, which drove my sunglasses into my face. Broke my nose, profuse bleeding, man it hurt. My first though was, did I crush my face. Second thought was, my wife is going to be really p!ssed.

    Bystanders called 911 and my wife; EMS came and put a splint on me, made sure I was stable, and my wife drove me to ER. Got 13 stitches in my face in 4 spots, and a temp splint. Went to the ortho the next day, and he tried to set it (photos attached). No luck, so 5 weeks ago tomorrow, I had almost the exact same plate as xcguy put in my arm (x-ray looks almost identical)


    I'm not laughing at you, really, I'm just kinda cringing inside at what it must have been to have stopped yourself with your face. And your left hand! They tried to hang my hand from the same kind of device but for some reason it just wouldn't stay attached. So they lay my wrist down on the table and stuck a big needle down INTO the bone. That was fun. Then after whatever heavyduty painkiller took effect the doc put his thumbs on the top of my mushed radius and pushed down as hard as he could to try to get it back into place. I can still hear my high-pitched wail of pain, totally involuntary. Aaaahhh!!! Anyway, when he got done with his fun they brought in two other orthos, they looked at my xrays and my wrist and in unison they said "If that was my wrist I'd have the surgery and a plate installed".

    Don't just ask about the JAS device (go onto their website and check it out) demand it. A lot of docs/pt people don't know about them. Fortunately mine did. If they b!tch and moan about the cost (it ain't cheap) just pay the difference. It's worth it.

    You should be getting your cast off about now. Time to start PT! How's the face?
    So it seems to me to be, this thing that I think I see.

  53. #53
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    My thoughts exactly- now that's a good look!

    Face has pretty much healed up-working the scar tissue over my left eye, on my nose, and my lip. Probably will be starting a cortisone regimen for those in the near future.

    I actually went to two orthos- the photos are at the first one. Hung my arm in the torture device, gave me a big ass shot in the wrist, and then mashed and poked the crap out of it trying to get it back in place. No luck- still about 1 mm out. He referred me to a hand specialist, who recommended the surgery and plate. (FWIW, while the shot in the wrist hurt like hell, it was nothing compared to the shot in the lip for stitches; that elicited an involuntary yell, and a threat of bodily harm to the ER doc. Hurt bad enough that I chose no shot for the cut by my right eye.)

    I got the brace off last Thursday, and started PT yesterday. Looks like I am one of the lucky ones. Already have about 70% grip strength, and 60% ROM. Tons of exercises to do, and I go back once a week to check progress. Next couple weeks will tell.

    The real sickness about all this is the rest of the parts of my new bike arrived yesterday- can't wait to get it built and riding again.

  54. #54
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    Two months since starting PT, and...

    - I am at approximately 70% strength and range of motion; 100% pronation, 65% supination, 70% extension, 80% flexion, 35 kg grip (normally 55-60)
    - I go to physical therapy four times/week, and acupuncture twice/week
    - I take supplements of calcium, Vitamin D, Vitamin C, MSM, glucosamine, and chondroitin, and apply Vitamin E soybean oil to the scar
    - I try to go to hot springs 2-3 times/week
    - I do the NASA-approved wrist rehabilitation stretches three times/day (though morning and lunchtime are difficult)

    Not exactly a whole lot of pain, but it feels really stiff in the morning. However, I think I'm going to hold off on the JAS for now... I'm doing ok with PT, and I really can't afford it. Mistake?

    Incidentally, Japan is not a bad place to break your wrist:
    http://www.keepingpaceinjapan.com/20...ing-power.html

  55. #55
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    Did my first ride today post crash

    Wrist is healing nicely. Only rode for about 30 minutes, but no pain. Have almost 100% range of motion, other than bending my hand backwards; only have about 50% there. Still stiff and sore at the extremes of RoM, but getting better.

    8 weeks into this ordeal I feel extraordinarily lucky. Probably go for an hour tomorrow and see how I do.

  56. #56
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    man down....

    Add another guy to the man down list. I destroyed my left wrist right at the end of February while snowboarding out at Brighton in Utah. One of those sunny days taking hot laps through the park with my friends pushing each other more and more each run. Well, someone's ticket had to come up, and unfortunately it was mine that day. The last jump in the jump line decided to toss me a beating, and that it did. I fell off axis in the air from about 10 to 15 feet in the air during a rotation, extended my hand out to break my fall, and the rest is history. Distal radial fracture (almost through the skin) and a broken scaphoid. I knew something happened, just took a minute to figure out what it was. I looked down at my wrist and it looked like someone beat me with a sledgehammer. I hopped up and rode down to the "on mountain emergency room". Fortunately there was a Dr. who was able to give me a large needle to the wrist and squeeze it all back into shape (well as best as he could). Fortunately for me I was flying home the next day. Went to 2 ortho's, both of which told me they couldn't help me. That was a sinking feeling and a real reality check. Made it to the third ortho who made me feel much better.....he said, "you really did it to yourself but I've seen worse". Funny how that made me feel 100% better. 2 days later I had a plate and 10 screws put into my wrist. Luckily I had no real reaction to anesthesia or anything and the pain wasn't too bad during the days after.

    I went for my follow up appt and it was then discovered that my scaphoid was in half too. The cat scan never showed this, and this is typical from what I hear and read when you have a really high energy impact. Went for a MRI to confirm and 2 days later, I was in the OR once again. That surgery was a much less involved than the radial fracture (1 screw).

    Here I am now almost 3 months out from my injury and things are going ok I guess. My ROM sucks, but now I'm using a JAS device, well actually 2 devices. Fortunately my insurance covered them. You no longer rent the devices from JAS, they are all purchased now. If insurance doesn't cover them for you, they run about $1000 per device (for the wrist). I've only been using them for under a week but they feel good. So much of this injury is mental too. Just seeing your wrist move in new directions is a great feeling, some sense of progress during hard times. My pronation is pretty good, typing with both hands. Supination is terrible, but getting better slowly.

    As everyone else mentions, the scar tissue is brutal. Being that I have hardware, no ultrasound can be used to break up the buildup. So I'm relying heavily on the JAS to do the job. We'll see what happens. I never had a cast, just the surgery and a brace for about 1.5 weeks or so. My ortho stressed to me, "we want to get you moving asap". If this ever happens to you, look for a Dr. who has done a fellowship in hand/wrist surgery. As most of you guys are, I'm very active. Not being able to ride or play golf is pretty much killing me this time of year. I was able to run a marathon 2 weeks ago (which was about 2 months or so after my surgeries) w/o any issues so that was nice. I broke my right arm years ago but was able to get away with just a cast. This injury was brutal.

    Thanks to all of you guys on this forum, especially XC Guy who turned me on to JAS. I worked with the rep last week and the splints are great, THANK YOU for the direction and advice. Also, just knowing there are others out there sidelined like me is reassuring (misery loves company) and that there are many success stories about recovery. I guess patience is key. Again, thanks to all of you guys for your words of wisdom and your stories, it's pulling me through some hard times right now for real. To all of you who have recovered or are near 100% recovery, enjoy the riding and the outdoors always.

  57. #57
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    Yo Positive

    I did three 30 minute sessions a day for four months with my JAS device, all of it bending my wrist/hand backwards. I already had my wrist-bending-down so I didn't have to work on that.
    Mainly because I was casted down and the "hard fill" fokked up my wrist bones for me trying to bend my wrist up and back.

    But I also had to work on my palm up/palm down ROM, which was 20 minutes as well for three sessions, plus when I was at stoplights, etc. What worked the best for me was to make a fist, turn my palm upwards at far as it would go then grab my wrist with my left hand and try to turn basically my forearm one direction, then the other direction. That took the pressure off my ulna and transferred my twisting motion to my elbow area which seemed to be the sticking point. Oh, yeah, and pushing my fingers down into a fist under hot water every morning. If you weren't casted maybe you didn't stiffen up as bad as I did. Or get as weak.

    So, four months of working diligently on my ROM. Check my pics above as to what I finally got. Not back to "normal" but I'll take what I can get. Good luck.
    So it seems to me to be, this thing that I think I see.

  58. #58
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    re:

    The pictures of your x-rays look very familiar! I have the same sort of plate and screws in my wrist as well. It took me about a month to be able to open my hand the whole way, but now it feels much better. I can actually make a real fist and straighten all of my fingers out. My grip strength in my good hand is 130lbs while my grip strength in my bad hand is at 50lbs......up from 23lbs a week and a half ago. That was some encouraging news to hear. I'll take your advice with the palm up/palm down exercises. I tried to carry a pizza the other night with my bad wrist/hand, that was a joke. Well, time for session #1 of the day with my JAS device(s).

  59. #59
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    Wow, glad I found this thread. Add me to the growing list of distal radial fracture victims. I broke mine on April 17th. (First day of Sea Otter practice.) It was a really lame fall, nothing spectacular at all. I knew something was wrong immediately though, but I was in serious denial and kept telling myself it was just a "bad sprain." I have to give a huge thanks to my buddies for helping me out and making sure I was ok.

    I thought it was prudent to go to the urgent care that night and at least get some verification on what was going on in there. Sure enough, three big fractures of the radius (both corners and one big lightning bolt crack starting at the joint and going down the length of the radius a few inches) as well as breaking off the tip of the ulna. (They called it the growth plate.) The on call doc said it would need surgery and ASAP.

    Well, as it turns out, quite fortuitous actually, I had just had complete shoulder reconstruction three months earlier (on the same side too!) and had a follow up appointment with my ortho surgeon the following Monday. We took some fresh x-rays and he had the same prognosis - the wrist was going to need surgery. My ortho got me in that Friday and now I'm the owner of a 4-1/2" plate and ten screws holding it all together. Turns out the exterior, back of hand side, distal radial was "mush" and displaced 3mm. Doc likened it to trying to snap a green tree branch. It doesn't break, it just freys into a bunch of strands. (I'll never ride with a watch on again!) I really think that between the watch and my elbow guards, it didn't allow my wrist to bend enough and that's what caused the break. (I've already got the screw in my scaphoid in the other wrist that taught me the make a fist and roll when falling.)

    So it's 3 weeks after surgery now, the splint is off and I'm in a removable brace for another two weeks. All things considered, I have decent range of motion given the time frame. It's still really big and swollen looking and hurts like hell at times. PT starts in about another two weeks. (FWIW, my ortho surgeon is currently the SF 49ers team physician. He's clear on my physical activities (I race expert DH) and so far hasn't mentioned the JAS device - whatever that means.)

    Our groups annual Whistler trip is scheduled for early September and I'm wondering if it's going to be manageable strength and range of motion wise?



  60. #60
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    It amazes me how many of you didn't get casted

    Even if you got the hardware I got you just were in a splint of some sort. I bet that's why it took me so long to get my strength and mobility back--6 weeks locked up in a hard cast and everything just goes to sh!t.

    You'll hear about JAS (www.jointactivesystems.com) from your PT guy. Maybe. Welcome to our Dubious Club of Busted Peeps.
    So it seems to me to be, this thing that I think I see.

  61. #61
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    Quote Originally Posted by xcguy
    Even if you got the hardware I got you just were in a splint of some sort. I bet that's why it took me so long to get my strength and mobility back--6 weeks locked up in a hard cast and everything just goes to sh!t.

    You'll hear about JAS (www.jointactivesystems.com) from your PT guy. Maybe. Welcome to our Dubious Club of Busted Peeps.
    Well, when I broke the scaphoid in my other wrist, I was in a cast up to my elbow for 16 weeks! Last set of x-rays showed minimal union and surgery was really pushed. In the end I'm glad I did the surgery as I was completely over being in a cast. I ended up spending 1-1/2 weeks in the splint and then PT for a good long while. That was about 2-1/2 years ago now and everything is fine. I have ~95%+ ROM in the wrist and no elbow problems. Only problem is once in a while it gets "stuck" and I have to back out of whatever direction I was moving it in and start over. It's very infrequent though.

    Just gone done looking at the JAS thing (thanks for the heads up guys!) and I'll be calling my surgeon tomorrow for a referral so that the insurance will cover the costs.

    Lastly, to everyone else that has received a plate and multiple screws in their wrist, how long did it take until all the swelling went away? Mine looks almost freakishly large at the moment.

    Oh yeah, one more thing, to those about to have this operation or are ever unfortunate enough to have to go through it, get the nerve block and the sedative. It's SOOO much better than having to deal with the general anesthetic. Your arm will be numb anywhere from 12-24 hours, but at least you get to go home to YOUR house and be in familiar surroundings.



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    just broke my right wrist Thursday at 6:30p riding up in ravensburg state park.i'm a righty and one finger typing with my left really sucks.i broke both bones at the wrist end and ended up with 2 plates.in a soft cast up to my elbow.it's so nice outside and here i sit on the computer.it's nice to read people's stories of coming back from an injury that sounds like mine . i know whaa whaa whaaa -- but thanks xc guy and others !!!!! good mental therapy, if nothing else !

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    73cuda

    I can't say any more than has been said by others on this thread. Being hurt sucks, typing with one hand sucks, but...like I kept telling myself, instead of breaking my elbow or my head "all I have is a broken wrist". Try it
    So it seems to me to be, this thing that I think I see.

  64. #64
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    Wow! a whole thread for people like me...

    I got Collie's fracture on March 21, 08.
    It required a plate and 13 screws to fix.
    Two months later, I, like others, am having problems with stiffness in the morning, but I can at least ride now.
    The riding is a little boring, because my right hand is still so weak, but I can float a jump, as long as I don't need to use strength in my right hand.
    I thought it was a little odd, that my surgeon took me out of the cast, just two weeks after I broke it, but I see that's not uncommon, after reading some of the replies.
    My PT says I'm doing well, but the whole thing is incredibly frustrating.
    One minute you feel everything is pretty normal again and then you get reminded, that you can't even comb your hair or open a beer.

    P.S. To answer a question above. My wrist, two months later, is still swollen a lot. It's about a half inch thicker and a quarter of an inch wider, although the rest of my forearm and hand, are pretty much normal looking again.
    My surgeon said I'll have noticeable swelling for up to a year.
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    Add Another Notch

    Broke my distal radius a little over two weeks ago. I was in post-ride hucking session when I biffed the landing off a 5 footer (pulled the bars bit too far right, which I tend to do when I'm tired). Went somersaulting through a rock garden, hit my right radius on a boulder, and now I'm off my bike. It was Sunday evening, I went into denial and so we went out for beers. The waitress said, "dude, your arm might be broken as swelling set in." Still, I didn't go to the doctor until the next day (after a very painful, throbbing night). X-rays showed a HORIZONTAL, not vertical break through the radius from the side impact into the joint.

    My first question: "When can I get back on my bike."
    Answer: "6-8 weeks." Which I have to, because I'm going to Moab/Fruita August 1st. Which means I need to be back riding and getting back in shape at least 2 weeks prior.

    Reading this thread, I consider myself lucky. My hand feels strong. Even in a full-length cast, I am easily typing using my right hand. I can bend my right fingers as high as my left. Having gone through this experience (and others) here's what I've learned:

    1. Armor. Everyone who saw the crash is asthonished I wasn't hurt worse. I barely even suffered any abrasions, even though I was down in the rocks. Why? I was wearing full arm and leg armor. The bummer is that the Roach Rally FR arms do a great job protecting the ulna, but only have fabric covering the radius. And NO protection on the wrist.

    2. Protect Your Joints. I frequently wear armor, but always wear pads on my elbows, knees, and now you can bet I'll wear wrist braces. Maybe ankle biters too. I don't care if stresses are directed elsewhere, just as long as they're directed away from the joints, cuz that's where long-term pain and ROM become an issue.

    3. Know When to Quit. That weekend, I made 22 hour drive from CA to TX straight through. Hit down, called my bud, and rode for 2 hours. Went out for margaritas that night, stayed up late. Next day's ride, I performed like crap. I was obviously tired. Riding a 40lb DirtBag, not cleaning sections I normally do, being real sloppy on my lines. Normally I don't huck when I'm tired, but I did it that day. I even thought 3x about it, then I did it any way. Nailed a few drops, felt good, then crash. Stupid. 2d year in a row I've put my annual trek to Moab at risk (biffed drop last year = stitches in right leg = ARMOR).

    One last thought on this. Over the years, I've noticed how injures/crashes seem to run in streaks for me and my buds. It stunned me me how right before her unfortunate crash Tara Llanes remarked that she'd been hurt more in the last 3 months than in the last 3 years. For me, I rarely take time off. I ride every day, even when I'm tired. Now I've got 6-8 weeks off.

    Maybe. I get a short-arm on the 9th and think I'll be able to steer my bike.

  66. #66
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    Woo-hoo! After this diagnosis:

    <table width="100%"><tbody><tr><td class="cdata">FINDINGS: Frontal, lateral, and oblique views of the left wrist show </td><td> </td></tr><tr><td class="cdata">comminuted intra-articular fracture of the distal radius with </td><td> </td></tr><tr><td class="cdata">approximately 3 mm distraction of the major fragments of the </td><td> </td></tr><tr><td class="cdata">articular surface but no significant depression. There is slight apex </td><td> </td></tr><tr><td class="cdata">dorsal angulation. Transverse fracture is also noted at the base of </td><td> </td></tr><tr><td class="cdata">the ulnar styloid. </td></tr></tbody></table>

    I've been cleared to participate in all normal activities with no restrictions! I still have some pain at the ulna styloid and the back of the wrist, but my surgeon says that'll go away with time.

    Oh yeah, the x-ray room was backed up due to a serious trauma patient, so my doc took me over to another room where they have another x-ray like machine which shows you real time movement. Crazy as all get out watching your bones move and seeing all the hardware in there. The wrist joint is clear and free and none of the screws protrude anywhere. I'm really amazed at the body's ability to heal so quickly, even at 40!

    Healing vibes to all those still under wraps - it will get better!

    edit: forgot to add that Guitar Hero really helps build the muscles back up - Rock on!!



  67. #67
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    Quote Originally Posted by Surfinguru
    Woo-hoo! After this diagnosis:

    <table width="100%"><tbody><tr><td class="cdata">FINDINGS: Frontal, lateral, and oblique views of the left wrist show </td><td> </td></tr><tr><td class="cdata">comminuted intra-articular fracture of the distal radius with </td><td> </td></tr><tr><td class="cdata">approximately 3 mm distraction of the major fragments of the </td><td> </td></tr><tr><td class="cdata">articular surface but no significant depression. There is slight apex </td><td> </td></tr><tr><td class="cdata">dorsal angulation. Transverse fracture is also noted at the base of </td><td> </td></tr><tr><td class="cdata">the ulnar styloid. </td></tr></tbody></table>

    I've been cleared to participate in all normal activities with no restrictions! I still have some pain at the ulna styloid and the back of the wrist, but my surgeon says that'll go away with time.

    Oh yeah, the x-ray room was backed up due to a serious trauma patient, so my doc took me over to another room where they have another x-ray like machine which shows you real time movement. Crazy as all get out watching your bones move and seeing all the hardware in there. The wrist joint is clear and free and none of the screws protrude anywhere. I'm really amazed at the body's ability to heal so quickly, even at 40!

    Healing vibes to all those still under wraps - it will get better!

    edit: forgot to add that Guitar Hero really helps build the muscles back up - Rock on!!
    Cool.
    I have a very similar problem, with multiple breaks into the radius' joint.
    I have three larger fragments of bone that broke off, plus many smaller fractures in the larger pieces and what was left of my radius.
    I too have pain in the top of my wrist and at the end of my ulna.
    My ulna was not broke in any way, so I have no Idea, why I have more pain and discomfort there, than at the end of the radius.
    I also have a transference of sensation, from my incision, to the palm of my hand. If I tap my incision below the wrist, I feel it in my palm.
    That kinda gives me the "creeps".
    Communist Party Member Since 1917.

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    JAS equipment

    i read about your wrist injury that happened in 2006. i did the exact same thing to mine. just got cast off yesterday. id have never dreamed itd be this difficult to get put back together. my question is about the JAS you reccommend. i have no insurance and was wondering if youd be interested in selling yours or if theres any other sites you'd suggest for exercises to do at home.

  69. #69
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    Quote Originally Posted by pippylou
    i read about your wrist injury that happened in 2006. i did the exact same thing to mine. just got cast off yesterday. id have never dreamed itd be this difficult to get put back together. my question is about the JAS you reccommend. i have no insurance and was wondering if youd be interested in selling yours or if theres any other sites you'd suggest for exercises to do at home.
    I haven't been on this forum for a long time. I just clicked on it for curiosity's sake and here's another post on my thread. I feel your pain! My insurance provided the JAS device (so it was a rental paid for by Kaiser) so I don't actually own one.

    I know what I did to do pt at home but I can't really say my regimen is the best course for your particular injury. Not having insurance sucks but you should see a pt person who specializes in hands/wrists (or Occupational Therapy person) and get them to line you out.

    And you need to do that now because it's important to work on your range of motion as soon as possible. Don't use "no insurance" as an excuse. Max out a credit card if you have to. The time is NOW for pt.
    So it seems to me to be, this thing that I think I see.

  70. #70
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    Hey XCGUY I had nerve damage in my knee surgery's and the left side below my knee cap is still that numb feeling 2 1/2 yrs later. My PT guy told to take dish rag get all soaped up and let it dry in the sun so it is crispy feeling. Then scrub the heck out of the area and it will make so it isn't so shocking when you hit it. It sorta worked for me but I'm having 1 or 2 more coming April so I expect more damage
    1.. 2.. 3... 4...........FIFFFFFFF !!!!!!!!!!

  71. #71
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    PT peeps have a patient do things the patient wouldn't have thought of himself. After I got my cast off my hand was basically this thing at the end of my arm that was helpless. The top layer of skin came off and the skin underneath was "new" and didn't know how to react to stimuli.

    She had me grab a towel as best I could and rub my kitchen counter top back and forth, just to get some mild sensation going into my palm. She also had me attempt to grab coins off a table with my thumb and index finger. Simple stuff, right? In the meantime I'm doing range of motion stuff for my wrist.

    Bottom line is, with all the work I was doing to stretch out my wrist to its former range of motion, I was teaching my hand to be a hand again. Took a long time to come back. A guy I spoke with, who broke his wrist skiing, said he couldn't "trust" his hand for a year and a half and that was about the same for me. As in, I could finally reach for something with my right hand (doing whatever, picking up something, twisting something) without thinking about it.

    I can tell you it's been about 2 1/2 years now and the one thing I do think about is NOT going OTB. It's more my knees and shoulders I wonder about if they'll hold up on long rides, not my right wrist.
    So it seems to me to be, this thing that I think I see.

  72. #72
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    broken wrist

    I broke my radius in 3 places and broke off the top of the ulna November 12 at Boyette Ridgeline near Tampa . Had a plate and 5 screws used to help fix the radius and 2 pins to help align the top of the ulna. Four weeks of therapy started 4 weeks after the injury. Light weight lifting, on road biking and racquetball 8 weeks after injury. At 12 weeks muscle strength maybe 80%, some simple off road riding and flexibility bending the wrist backwards about 80%. Looking forward to getting back 100% but think it will be 3 to 4 months. Good luck with your recovery.

  73. #73
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    Holy Resurrected Thread, Batman!

    I'm fine now. It took a long time but I'm using my right hand like I'd never had an injury. Mostly. See my reply on this thread:

    When good days go bad.....

    One thing that didn't happen is I haven't re-injured it again. DIRTJUNKIE's recovery has been a little more problematic and I wish him the best of luck.

    "Broken wrist" can mean many things. Some call breaking the bones in the lower forearm a "broken wrist". I shattered what I would call my "wrist" the hinged area from my hand to my arm. A lot more stuff was fokked up than just my radius and ulna.
    So it seems to me to be, this thing that I think I see.

  74. #74
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    Fracture Diagnosis?

    xcguy,

    I fractured my distal radius on 5/5/12. Volar Barton (shearing), comminuted (multiple pieces), and intra-articular. It sounds like you had some of the same complications although you broke the ulna as well. Did you (or anyone else here) have DRUJ instability? TFCC tear? I'm about 5 weeks post-surgery (volar plate ORIF), and it seems as if I'm having some of these additional complications that weren't addressed with the surgery. I'm hoping I don't need another one, but I'm thinking I might. My affected arm (right) has much more dorsal ulnar prominence than my left arm.

    My range of motion is pretty poor, which is somewhat expected 5 weeks post-surgery, but I feel like the stopping point is bone on bone, or at least something hard. Can scar tissue build up that quickly to do this? Has anybody else had this feeling? There is a lot of pain when I reach the end of the range of motion, when it feels "bone on bone." Any information regarding this would be extremely appreciated. I see my surgeon in 5 days, but am thinking about scheduling a 2nd opinion.

  75. #75
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    Quote Originally Posted by RazorLake View Post
    xcguy,

    I fractured my distal radius on 5/5/12. Volar Barton (shearing), comminuted (multiple pieces), and intra-articular. It sounds like you had some of the same complications although you broke the ulna as well. Did you (or anyone else here) have DRUJ instability? TFCC tear? I'm about 5 weeks post-surgery (volar plate ORIF), and it seems as if I'm having some of these additional complications that weren't addressed with the surgery. I'm hoping I don't need another one, but I'm thinking I might. My affected arm (right) has much more dorsal ulnar prominence than my left arm.

    My range of motion is pretty poor, which is somewhat expected 5 weeks post-surgery, but I feel like the stopping point is bone on bone, or at least something hard. Can scar tissue build up that quickly to do this? Has anybody else had this feeling? There is a lot of pain when I reach the end of the range of motion, when it feels "bone on bone." Any information regarding this would be extremely appreciated. I see my surgeon in 5 days, but am thinking about scheduling a 2nd opinion.
    You're using terms that my surgeon didn't use so I'm guessing as what it is you're talking about. My radius was pretty much "smushed and shattered" was how she described it. The plate she put in gathered up all the scattered parts into one rough piece. The fracture of my ulna wasn't addressed and healed on its own but it sure hurt like a sumb!tch when I tried to turn my wrist over.

    You're only out over a month from your surgery. Of course your range of motion sucks but you haven't been specific in which direction. I was just getting my cast off six weeks after my surgery and I had no range of motion moving my hand back but had it moving my hand down (which surprised the docs). Turning my hand over to the left, over to the right I really had to work on. I had zero strength in my hand. Turning the key in the car door was impossible until maybe 5 months after I got my cast off. When I first ventured back into the gym about 4 months after my fall I started crying because I was able to pick up a 2 1/2 lb dumbbell without it coming out of my weak grip.

    The "bone on bone" feeling you're describing is sort of how I felt when I tried to move my hand up and back. The articulating bones on top of my hand (like the way fish scales move over each other) had gotten scar tissue in between them (from having my hand casted pointing down) and the movement would just stop. I worked on that motion (if you've read this thread you know about the JAS device I used) the most and got 60 percent of that movement back. No pushups for me.

    The bones in your forearm cross over each other when you're turning your hand to the left/to the right and all of that needed getting back but there wasn't any scar tissue to deal with, just underuse from being in a cast.

    It's been years since my accident and except for my hand not moving back like my left hand I have no after affects. I never think about my right hand and I'm back as strong as I was the day before I fell. Take the long view.
    So it seems to me to be, this thing that I think I see.

  76. #76
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    XC Guy

    Just a couple of symptom questions. I know that everyone's injury is not the same, but I know yours was pretty complicated as is mine. I'm wondering if you had substantial pain when picking things up from the side, such as a book, especially when rotating the object. This also happens to me when I turn a doorknob, and even just occasionally with gripping things. I also have some clicking in my wrist with flexion/extension and am extremely concerned I may have a torn scapholunate ligament in there. From what I've read, the sooner these are treated the better. It's now been 10 weeks since my crash and the pain hasn't gone down much. I've addressed this with 3 different hand surgeons (and another retired one i know personally). They all have different opinions on this, but none of them seem to want to address this scapholunate ligament tear possibility at this time. Did you have some of these same symptoms xcguy? Anybody else out there? I feel like I'm doing all I can to make sure I'm on the correct road to recovery, but it's frustrating to keep getting all the different opinions. Thanks for any advice you can give, or details of your symptoms through your healing process. If I can't get this figured out soon and feel comfortable with the diagnosis I'm not sure what to do. Perhaps go to the Mayo Clinic. Anybody have any experience dealing with this kind of issue?

  77. #77
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    Quote Originally Posted by RazorLake View Post
    Just a couple of symptom questions. I know that everyone's injury is not the same, but I know yours was pretty complicated as is mine. I'm wondering if you had substantial pain when picking things up from the side, such as a book, especially when rotating the object. This also happens to me when I turn a doorknob, and even just occasionally with gripping things. I also have some clicking in my wrist with flexion/extension and am extremely concerned I may have a torn scapholunate ligament in there. From what I've read, the sooner these are treated the better. It's now been 10 weeks since my crash and the pain hasn't gone down much. I've addressed this with 3 different hand surgeons (and another retired one i know personally). They all have different opinions on this, but none of them seem to want to address this scapholunate ligament tear possibility at this time. Did you have some of these same symptoms xcguy? Anybody else out there? I feel like I'm doing all I can to make sure I'm on the correct road to recovery, but it's frustrating to keep getting all the different opinions. Thanks for any advice you can give, or details of your symptoms through your healing process. If I can't get this figured out soon and feel comfortable with the diagnosis I'm not sure what to do. Perhaps go to the Mayo Clinic. Anybody have any experience dealing with this kind of issue?
    Yeah, your injury isn't my injury. 10 weeks after my crash I couldn't even pick a penny off the kitchen counter, much less try to turn doorknobs. I did everything with my left hand including shifting my tranny, turning the key in the ignition etc. My right hand was just along for the ride for about three months. Actually using it as a hand was about four months away from getting my cast off. I wasn't diagnosed with a scapholunate ligament tear.

    Pretty amazing all your docs can't give you a better diagnosis. Regardless, I had pain for a long time. None now, thank god.
    So it seems to me to be, this thing that I think I see.

  78. #78
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    Symptoms

    Thanks for the response xcguy. It's awesome that you're still on here helping to answer questions so long after your own injury.

    You weren't able to use your right hand like a hand until 4 months after the cast came off? In my case the cast came off 9 days after surgery, but I didn't have an ulna fracture. Instead I had an intra-articular (into the joint) fracture with a dislocated lunate bone. I'm very frustrated with the lack of consensus with my diagnoses. It seems like more art than science.

    Did you have pain (often sharp) with the rotational motions or picking something up from the side like a book? This is a very frustrating injury. I seem to have good range of motion for this point in my recovery, but I'm afraid these other symptoms I am experiencing are complications related to some other undiagnosed things (scapholunate ligament tear? torn TFCC?) From what I've found with research online (maybe not the best thing), if these things aren't taken care of they can lead to worse problems down the road. Anyway, at this point I'm trying to find out if other people had my same symptoms and what type of injury they actually had. I certainly HOPE I don't have any of those other complications, especially since none of my surgeons seem to be interested in exploring them as options. Thanks again for any info.

  79. #79
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    Quote Originally Posted by RazorLake View Post
    Thanks for the response xcguy. It's awesome that you're still on here helping to answer questions so long after your own injury.

    You weren't able to use your right hand like a hand until 4 months after the cast came off? In my case the cast came off 9 days after surgery, but I didn't have an ulna fracture. Instead I had an intra-articular (into the joint) fracture with a dislocated lunate bone. I'm very frustrated with the lack of consensus with my diagnoses. It seems like more art than science.

    Did you have pain (often sharp) with the rotational motions or picking something up from the side like a book? This is a very frustrating injury. I seem to have good range of motion for this point in my recovery, but I'm afraid these other symptoms I am experiencing are complications related to some other undiagnosed things (scapholunate ligament tear? torn TFCC?) From what I've found with research online (maybe not the best thing), if these things aren't taken care of they can lead to worse problems down the road. Anyway, at this point I'm trying to find out if other people had my same symptoms and what type of injury they actually had. I certainly HOPE I don't have any of those other complications, especially since none of my surgeons seem to be interested in exploring them as options. Thanks again for any info.
    Yeah, I had pain turning my hand over one way then the next. I had pain doing everything!
    Your best hope for advice I guess would be to research other places than this forum for specific advice about your symptoms. I have to say, I never got frustrated, I just put my head down, took the long view and figured I'd do my PT, work on my strength later and what will be will be. After 1 1/2 years I could finally "trust" my right hand and started reaching for things with it instead of my left. Also, by that time I'd become ambidextrous--to look on the bright side. The inconvenience of being one-handed was what pissed me off the most. Like tying a shoe one handed or opening a can or jar in the kitchen.

    Bonus: now in the gym I can do shoulder shrugs with 100 lb dumbbells and not worry about my right hand just flat coming off the end of my arm. You don't think about those things pre-injury. Good luck.
    So it seems to me to be, this thing that I think I see.

  80. #80
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    Distal radius fractures are often very slow to heal due in part to a peculiarity of the vascular supply to that part of the bone. Ditto for distal tibia fractures.

    I'm wondering if any of you had to use a Electromagnetic bone stimulator to get the repair to heal? I did, with my distal tibia fracture. It was fractured in 3 places, and just was not building bone back fast enough. The stimulator did the trick.

  81. #81
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    Quote Originally Posted by Ray Raton View Post
    Distal radius fractures are often very slow to heal due in part to a peculiarity of the vascular supply to that part of the bone. Ditto for distal tibia fractures.

    I'm wondering if any of you had to use a Electromagnetic bone stimulator to get the repair to heal? I did, with my distal tibia fracture. It was fractured in 3 places, and just was not building bone back fast enough. The stimulator did the trick.
    I didn't use the bone stimulator.
    So it seems to me to be, this thing that I think I see.

  82. #82
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    Want to share my case...

    .. want to share my case...

    Injury: 02.06.2012
    Diagnosis: Distal Radius Fracture - Multiple pieces (7 pieces)
    5 weeks: Hard Cast Full arm
    3 weeks: Hard Cast haft arm... when my elbow was free, it was a tremendous advanced for me.
    4 weeks: Soft Cast and therapy in hot water, recovering movement and strenght.

    Since Day 1 there has been pain must of the time... I prefer not to take any kind of pain killer because I feel some relief, if theres pain it is healing...

    during 3rd week in soft cast and rehab I'm in the 60% of my motion and strenght (more pain). I know I will need more patience and time to improve in this sense. Time goes quick, in a close of eyes you are run out of this "long" process... take your time to enjoy your recovery... we must be careful if we want to enjoy our passion: Family and cycling
    Attached Thumbnails Attached Thumbnails distal radius fracture--4 months later-copy-bluetooth-exchange-folder1.jpg  


  83. #83
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    Update 5+ years later

    I haven't forgotten what it took to come back from my particular broken wrist. Lots and lots of PT then later strength conditioning of my right arm. I remember a moving crew bringing in a new dining table/chairs/etc into my new house back then. One of them was a firefighter who had the moving job as a second job.

    The firefighter had completely hosed his right wrist like I had a year before but he was moving some heavy stuff that day without worry. I marveled at how far he'd come as I stood there with my cast in the air wondering if I'd ever come back that fully.

    Well, I just moved my own self the past week (with help). I never thought about my right wrist being able to take whatever I asked it to (within reason). The one thing I had to not do was to grab like the end of a table and lift straight up, it didn't like that.

    But, now after the move is over, my right wrist/hand don't hurt me any more than the rest of me, which is all pretty beat up. I'd worked a lot on "moving moves" in my gym to get ready and it paid off. Good luck to anyone else out there coming back from your own broken wrist. Take the long view.
    So it seems to me to be, this thing that I think I see.

  84. #84
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    Thread from the dead.

    Just had a OTB accident up in Marquette on 10/7. Crossing a bridge that had a slight tilt to the left, my fat bike tire hit a wet spot, started to slide, and an drifted right off the side of the bridge. Obviously tried to break some the fall with my left hand.

    Had decent motion of the wrist after the accident, but could not put weight on the bars with that had.. Rode back to in-laws house and went to ER.

    On 10/9, surgeon looked at it, and said I had a break across the head of the radius, and thought I might have a Barton's Fracture too, but CT showed it wasn't complete. Everything is in place, so a half cast was put on, and I have my 3 week appointment on Tuesday. If everything is in place still, I'm probably looking at another 3-5 weeks in a cast.

    I have decent use of my fingers even now, and can even type with them as long as I lift my elbow enough to get my fingers on the KB.

    Hoping I'll be good enough early next year to get some fat bike riding in, but will see how things work and feel. Good MTN friend is a PT, and said he'll work with me to make sure I'm getting what I need. May look into a JAS depending on what my ROM is when the cast comes off.

  85. #85
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    Good luck on your recovery, dirt. You're way ahead of where I was at three weeks after my accident. I had no use of my fingers till months after my cast came off! But, like I've said many times on this thread, your injury is not my injury. I went sideways in my breaking motion and a lot of OTB injuries are hand breaking backwards.

    Anyway, after all this time I don't think about my past injury. Both my hands work "normally" and my right bicep is finally bigger than my left, just like the old days. Take the long view, don't get frustrated with your recovery, it will all come back eventually.
    So it seems to me to be, this thing that I think I see.

  86. #86
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    Welp, the piece shifted, and I'm going in for surgery today for a plate. Will let you know how it turns out.

    If I feel good enough tomorrow, we'll be headed up to Iceman in Traverse City for some beer and hanging out. Wife is doing the race on a tandem.

  87. #87
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    Good thread from the past.

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