Today was my 5 month post surgery check up after having wrist surgery to correct a bad snowboarding break. I busted my wrist on 2/10/13 and had surgery on Valentine’s Day 2/14/13… I will NEVER forget this Valentines… Ever! They gave me the gift of a metal plate and about 8 screws in my right wrist… Which also happens to be my dominant hand.
Barton Emergency Room ~ Tahoe, CA
Los Gatos Surgery Center
Now, I was told that at 8 months post surgery I could go back in and have the hardware removed. They want my Valentine’s GIFT back?! I told my friend who was with me when I broke my wrist that if I did decide to get it out I would gift wrap it and send it to him as next year’s Valentine’s Day present… HAHAHA! I blame him for the break, but it was totally just one of those things that happens. I was soo sooo lucky though! The bone didn’t puncture my skin and I didn’t break anything else. Thank goodness! The girl in the hospital bed next to me that day… Not so lucky. She broke both of her legs… and she like me, is a runner. I say IS a runner because I pray that one day she’s able to fully recover and run again.
Now I had options for the type of surgery I wanted. I had the option of one of the following (information provided by HOSPITAL FOR SPECIAL SURGERY):
Percutaneous fixation with pins and casting
Some types of fractures, while unstable in a cast alone, require only the addition of one or more pins to create a stable situation and enable treatment with a cast. The pins can be placed without the need for an incision and are done in the operating room under a regional anesthetic. The wrist is then placed in a cast until healing, at which time the pins are removed and therapy begun.
Advantages of percutaneous pin fixation include:
-
adequate stability for closed treatment
-
no need for permanent hardware implantation
-
minimal soft tissue or bony complications
-
less painful procedure
-
minimal scarring and no surgical incision
Internal Fixation (plates, screws, pins)
A common form of internal fixation involves an open surgical technique in which an incision is made over the fracture and a stainless steel plate with screws is placed to align the bone ends and prevent displacement or loss of reduction.
Advantages of internal fixation include:
- increased stability
- strategic placement of implants
- the lack of a need for an external device
- less obtrusive casting and potential earlier use of the hand
This may not be suitable for all fractures — possible complications of this technique include:
- loss of fixation
- improper positioning of the plate or screws
- infection
- the need for hardware removal
- nerve injury
- tendon injury or rupture
- stiffness
External Fixation
External fixation is a time-honored technique that involves using an external frame holding pins placed in the bone through small incisions on both sides of the fracture.
“While associated with a high rate of complications during widespread use thirty years ago,” notes Dr. Wolfe, “clinical and basic research has yielded newer techniques and devices, dramatically reducing complications and improving clinical outcomes with this technique.
In fact, recent large-scale randomized clinical studies suggest improved functional and clinical outcomes for selected fractures when compared with more invasive surgical techniques.”
Using the technique of augmented external fixation, the fixator is generally applied in conjunction with ercutaneous pins and bone graft to directly support the broken fracture fragments and reduce the need for traction to be applied by the fixator device. This allows the wrist to be placed in a comfortable position and the fingers to be used for resumption of lightweight daily activities almost immediately after surgery.
When the wounds are healed in 10-12 days, patients are allowed to shower and get the wounds wet, provided they keep the pin sites cleaned regularly.
- a proven, time-honored technique
- minimal soft tissue disruption/minimally invasive
- all hardware is removed (no concerns for airport security or tissue response)
- skin incisions result in minimal scarring
- bone graft may be used to support the joint surface
- equivalent or improved clinical, radiographic, and functional outcomes in selected fractures
Disadvantages of external fixation include:
- the presence of a bulky metal or plastic frame about the wrist
- protrusion of pins from the skin surface and the need for pin care
- inability to begin motion therapy of the wrist joint for several weeks after surgery
Possible complications include:
- wrist and hand stiffness
- pin tract infection
- nerve injury
- settling / loss of reduction
- re-operation
I opted for the Internal Fixation (plates, screws, pins).
BIONIC WOMAN ~ aka Dani
trying to work… NO FUN
As you can see, I did not LIKE being immobilized and wanted to be better as quickly as possible. I went to physical therapy twice a week for 6 weeks and wore a wrist brace everywhere to make sure I didn’t hurt myself again.
Random dudes ~ Bachelorette Party VEGAS! a la wrist brace
So here I am today… 5 months post surgery and I get to decide whether or not I want to have surgery again to remove the metal plate. I’m thinking I’m going to go for it and become the NON bionic woman that I once was… Here’s why. My doctor told me, more often than not, younger more athletic individuals opt to have the hardware removed as they can still feel it when exercising. Which is the issue I’ve been running into. Push ups and lifting weights is no longer enjoyable. YES! I did enjoy it before, but now my wrist is sore and I can feel pings of pain at the surgery site. The doctor explained this is because the tendons and nerves are growing around the hardware and when it’s being used they rub against it and that’s why I’m feeling pain. Who wants to live with that right? Looks like a new surgery date is in the near future for sometime in October. The recovery should only be about 4 weeks and then it’s back to business as usual.
