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Roswell

PAKISTAN
Topic initiated on Thursday, March 3, 2005  -  6:20 AM Reply with quote
Advice needed- Orthopedics Surgeon


Greetings All,
long time no see :) well....long story...i'm/was stranded...any way in short i had an accident last month and got fracture in my right wrist which is my working hand ....therefore i'm underground nowdays. i hve been wearing 'POP' cast for almost two weeks and recomended for at least six weeks. I've got something 'smith' fracture :s i dont know these code words but anyway i want to ask,
how long do i have to wait to get my gym started again ?
can I put off my shoulder supporter coz i dont wana live like that {darn it} and i dont feel any pain when i put it off...
my fingers are swelled out due to the cast, is this normal ?

ps i dont wanna goto the clinic to ask tese questions :)
Roswell

PAKISTAN
Posted - Thursday, March 3, 2005  -  6:25 AM Reply with quote
also, x-rays scanned images will be provided if required
regards
waseem

UNITED KINGDOM
Posted - Thursday, March 3, 2005  -  6:48 AM Reply with quote
Assallamu Alaykum brother

I am not an orthopedic surgeon but a general practitioner. If you get a better professional adv,then pleae ignore my comments.

You have been in an accident and have a wrist fracture. Whilst I can give general comments,each case can have specific circumstances, so some aspects of such a case are best answered by the doctor who is treating you face to face, as he/she knows the exact state of affairs.

In general, fractures involving upper arm take approx 6 weeks to heal. So you will have POP off in six weeks and possibly a repeat x-ray. If the healing is satisfactory, you will resume light exercises and then gradually build up to going back to Gym. You may observe that there may be some thinning of the size of your forearm due to muscle wasting and the strength in your rt upper limb may be reduced.This is due to lack of activity of muscles for six weeks on that side, thus gradually increase your exercises as recommended by your surgeon and physio. Do not go back full time to the gym the day after POP comes off.

I am not fully aware of the other injuries you sustained in the accident, If a shoulder brace or support has been given,then you may have had an injury in that area also. In my opinion if that is recommended to you then there must be a reason and I would adhere to that.

You normally get some swelling in the fingers distal to the POP.the reasons are that after an injury some degree of swelling does take place.This is taken into account when the POP is put on.
However you are given an advice sheet or told verbally that if there is discomfort or change in colour distal to the POP then it should be reviewed immediately to ensure that the POP is not too tight and affecting circulation. This is a clinical judgement rather than something I can reassure you on an e-mail.
These symptoms, if they are going to be present should be there, in the first few hours or a day of having the POP. You have mentioned that the POP has been there for two weeks so it is unlikely to be that. One other reason for the swelling is that there is some stasis or slowing of circulation in the part distal to the POP.sometimes the POP edge rubs against the hand and wrist and causes discomfort.
In summary! in such situations one face to face glance lasting a couple of minutes by a professional can reassure you much more than 5 pages of e-mail.

I hope that helps
kind regards
Waseem
Roswell

PAKISTAN
Posted - Thursday, March 3, 2005  -  7:12 AM Reply with quote
thank you very much doc bro waseem. one thing, i didnt get any injury to my shoulder, it is just a cover that holds my arm horizontallyso my question becomes , can i release my hand verticaly ?. rest is assured. but the biggggggggggg problem is, i got my exams up :( so......thisi si the type of exam where no supportr can help me out doing the test.... is this possible to cut of the very upper part of the pop covering only my palm so that i can hold a ppen(i can move my fingers very frequently and feel no pain at all ) :( oh my god im in great trouble... sniff sniff

Edited by: Roswell on Thursday, March 03, 2005 7:23 AM
waseem

UNITED KINGDOM
Posted - Friday, March 4, 2005  -  5:15 AM Reply with quote
Brother!
The size of POP applied has to be such that it immobilises the fractured joint completely.
The biggest disappointment is when you have had a POP for 6 weeks and it is taken off, x-rayed and found that healing has not taken place and you need the arm to be re-set and further POP for 6 weeks from that day.
My advice is not to cut or shorten the POP.It is unfortunate that you have an exam.
This is the time for patience, being your rt hand it must be putting limitations on a lot of activities. But you must want it to heal and not prolong beyond 6 weeks. So try to take things easy rather than looking for what or how far you can move it.
kind regards
Waseem
Loveall

PAKISTAN
Posted - Saturday, March 5, 2005  -  8:17 PM Reply with quote
Dear brother Roswell

AssalamoAlaikum,

I am a general surgeon. Brother Dr. Waseem has advised comprehensively to solve your problem according to the information provided. Continuing his advice I want just to add or explain few points as followings.

1. The aim of any fracture treatment is not only healing which is natural, but to achieve the useful FUNCTION that can only be achieved if there is satisfactory alignment of the bone ends. The satisfactory alignment is not only the answer but its maintenance too, which is the vital manoeuvre done by the POP. Therefore POP is the backbone of the forthcoming results, so it must be allowed to work as advised by the concerned doctor. If the POP is causing some problems, it may be revised after properly being examined by the doctor. The problems like pain, numbness, tingling sensations, inability to move of the fingers or colour changes etc must not be taken light and immediate consultation is mandatory.
2. Protect your POP from wetting as it loosens it, which ultimately impairs its function.
3. Making the limb vertical would do add to the swelling of the hand, and so it must be kept up with the sling, with periodic movements of the fingers.
4. After the POP is removed (after the said period), proper physiotherapy is vital to restore the full range of the movements.
5. You must not be worried too much. Be patient and thank God, as it is your wrist not the ankle- you can walk easily in and out of the home with your POP at the wrist.

Just for information for some others, POP is the abbreviation of Plaster Of Paris.

May God bless you and help improving your condition, Aameen.
Roswell

PAKISTAN
Posted - Friday, March 25, 2005  -  11:41 AM Reply with quote
Hi i'm back :), My cast is off now after 5 weeks and I can't move my wrist into every angles.Perhaps this is normal and I would be able to do that after some time no ? sugest me the best theropy.
Again, thank you Loveall and Waseem.
hkhan

UNITED KINGDOM
Posted - Saturday, March 26, 2005  -  9:38 PM Reply with quote
walaykum assalaam dear br. farhan

nice to have you back. may god bless you with quick recovery.
gud/mash'Allah that you are managing to type. Although its mostly your finger movements but it must be uncomfortable at the wrist joint. you must limit the movements and that shall help quicker recovery insh'Allah.

this is a non specialist advice though. You know I'm not an orthopaedic surgeon.

regards
Roswell

PAKISTAN
Posted - Sunday, March 27, 2005  -  2:28 PM Reply with quote
Awe so nice of ya, . You dont have to be a surgeon giving this adorable advice.

Regards,
Loveall

PAKISTAN
Posted - Monday, March 28, 2005  -  8:42 PM Reply with quote
Dear Roswell,

Assalamo alaikum.

You need now physiotherapy by a physiotherapist, after being seen by the orthopaedic surgeon.

You will be all right having all the movements restored, Inshaallah.
Roswell

PAKISTAN
Posted - Tuesday, March 29, 2005  -  7:37 AM Reply with quote
Orthopaedic surgoen, Syed Muhammad Ali Shah said that now use your hand in usual activites but dont lift any weight at all, this is the therapy.
Wassalam
hkhan

UNITED KINGDOM
Posted - Tuesday, March 29, 2005  -  8:22 AM Reply with quote
farhan can you please give him our contact and see if he is interested to join our drs comunity as we need an orthopaedic surgeon.
if he is happy, i could email to him with details

thnx
wassalaam
Loveall

PAKISTAN
Posted - Tuesday, March 29, 2005  -  7:35 PM Reply with quote
Dear Roswel,

You will have to act upon the advice of the ortho-surgeon. Daily activity is not out of physiotherapy.

May God help you!
Roswell

PAKISTAN
Posted - Wednesday, March 30, 2005  -  4:37 PM Reply with quote
AoA Dr. H Khan,
Yeah sure I would invite him but you know hes kinda celebrity here in Pakistan, Loveall may aslo heard of him, so I dont think he got enough time to use internet or something. But nevertheless, I would invite him in my next visit to him.
Regards,
hkhan

UNITED KINGDOM
Posted - Friday, April 1, 2005  -  11:27 AM Reply with quote
thnx

surgeon musa has mentioned physio.

a nice patient of mine gave me a link to put up for patients who need it

http://www.csp.org.uk/physiotherapy/az_conditions/more_information/f.cfm

even nonmembers can have some info from there

wassalaam
Loveall

PAKISTAN
Posted - Friday, April 1, 2005  -  8:24 PM Reply with quote
Assalamo alaikum,

Thank you sister Dr. Henna Khan for the useful link.

We can help one another, with the help of God.

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