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Topic: risk of lymphedema after wrist fracture

Forum: Lymphedema — Risks, tips for prevention, and info about products that can address the symptoms of lymphedema.

Posted on: Nov 27, 2010 11:43AM

scottysue2010 wrote:

I badly fractured my wrist 10 weeks ago,requiring manipulation to reset followed by plaster cast for 6 weeks since removal of cast and being fitted with brace and given physio therapy excersises I find when brace removed my fingers and thumb swell like balloons and become very stiff and painful,also hot and stinging,I have been diagnosed with periferal neuropathy several months ago,but I wonder if removal of affected lymph nodes could have an effect on fluid drainage,when I wear my brace I find I have more movement in hand and fingers and swelling reduces could I be suffering a form of lymphedema,under arm can also feel uncomfortable,any help or advice appreciated.I am new to site.

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Nov 27, 2010 01:23PM Suzybelle wrote:

Yes, the fracture could have triggered lymphedema.  If you can get your doctor to get you in to be evaluated by a qualified lymphedema therapist, that would be the best way to find out for sure.

Best of luck to you and I'm very sorry about your wrist fracture.

Dx 1/27/2010, ILC, <1cm, Stage I, Grade 2, 0/10 nodes, ER+/PR+
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Nov 27, 2010 02:18PM, edited Aug 20, 2013 06:16AM by kira

Scottysue,

  I have lymphedema, and I fractured my hand--a scaphoid fracture-- on my lymphedema hand--I'm still in the cast, and anticipate needing to really work on the lymphedema when I'm in the brace and hand therapy.

(Did you have a colle's fracture?)

  It's hard to sort out reactive edema from lymphedema, but you are at risk for lymphedema and the heat and swelling sound a lot like lymphedema. There's also a risk that the therapy, when it doesn't take into accout lymphedema, can make things worse.

The fact that your arm is bothering you is another clue that this may be lymphedema--as the whole "quadrant"--arm/chest are at risk, and if your hand is traumatized, it can upset things further up the arm.

I strongly suggest you see a qualfied LE therapist--I'll put in a link for how to find one--and if possible, try and get an OT who can do hand therapy  along with lymphedema evaluation. You'll need a referral from a physician.

www.stepup-speakout.org/Findin...

Lymphedema can be triggered by trauma--I initially got mine after bug bites, but various lymphedema therapists and women with lymphedema have also told me that when they use the techniques of lymphedema therapy with post-fracture swelling, it resolves so quickly, the doctors are shocked.

Let me know how you're doing, and if you need additional information.

Kira

(My cast comes off 12/7 and then I start with the brace/ therapy--I'm contacting an OT who does LE therapy to see if she'll do the hand therapy vs. my surgeon's office.)

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 27, 2010 02:51PM scottysue2010 wrote:

 Thank you both for speedy replies,I only know I fractured the radius and took a chunk out of ulna bone,no matter how often I massage my fingers and hand the swelling doesn't go down,still cannot properly straighten fingers or make a fist,can do better with splint on.

I see my physio on Monday weather permitting as we are covered in snow and ice and I don't want to risk further fall.

I appreciate your input,can lymphedema effect only fingers and hand as arm doesn't seem too bad.

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Nov 27, 2010 03:18PM kira wrote:

Yes, lymphedema can only effect the hand and fingers--I really think you likely have both reactive swelling from the break --sounds like a colles fracture to me-although colles involves mostly the radius--here's a good link, and it describes both our fractures and says that full healing takes up to a year!

Still, some lymphedema therapy should help with the swelling and the healing.

www.eatonhand.com/hw/hw020.htm

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 27, 2010 03:21PM kmmd wrote:

Scottysue: I can't give the good advice Kira can, just wanted to say "ouch" and send cyber hugs your way.  Broken bones suck, and lymphedema is the worst.

www.youtube.com/watch?v=vrpJD2... Keep breathing is my new motto. Kate

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Nov 27, 2010 03:31PM scottysue2010 wrote:

Thank you,and for link to fractures would say by look it was a colles fracture,plus the chunk out of ulna,my physio has said to massage fingers and hand towards wrist also to practice making a fist,cannot turn wrist or grip or hold anything,anything else in therapy you can suggest till I see her?thank you,

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Nov 27, 2010 03:36PM kira wrote:

Sue, I haven't started therapy yet, so I'll defer to your PT--gentle massage, and maybe try and squeeze a soft ball.

A year to heal, we have a long road ahead of us--and the fall happened in an instant.

Stay safe in the bad weather, and let me know, and I'll let you know how it goes.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 27, 2010 04:19PM scottysue2010 wrote:

 Good luck Kira,I appreciate your advice especially when you are in a similair situation.

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Nov 29, 2010 04:38PM scottysue2010 wrote:

Spoke to my physio today as unable to see her because of weather,she agrees recovery will be about 12 months,also suggests I see my doctor or check with orthopedic consultant on 13 th Dec regarding lymphedma,she thinks with my description I could have both.

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Nov 29, 2010 07:32PM, edited Aug 20, 2013 06:17AM by kira

Sue, I think the lymphedema consult is a very good idea--and will speed your recovery.

I'm anticipating needing a fair amount of rehab: I did speak to the OT who does a lot of lymphedema care, and she also does hand therapy--so I'll try and make sure that I get my rehab with her.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 30, 2010 02:54PM scottysue2010 wrote:

 Thanks Kira, have just read your story, I'msorry you are having problems in your work situation,I hope you get things sorted out to your benefit.

Good luck with the removal of your cast next week, will be thinking of you.

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Nov 30, 2010 04:05PM BoobsinaBox wrote:

Kia,

Thanks for the link with the explanation of the broken wrist issues.  While my issue is arthritis in the carpometacarpal joint of the thumb and the trapezium bone, the latter of which will be removed and replaced with a slice of tendon, I appreciate reading about your experience.  It is a different cause, but has some of the same kinds of issues, and a similar recovery.  My surgeon won't do the second one for at least 6 months, because of the increased LE risks (meaning no longer latent, but active).  I expect the first surgery in January, so hearing and reading about your experience is helpful, if scary!  Thanks for sharing, and may your PT go very well!

Dawn 

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Dec 1, 2010 04:48PM, edited Dec 1, 2010 04:50PM by scottysue2010

 Good luck Dawn, I have osteoarthritis in thumb as well also osteoporosis but not needing surgery.

I am going to phone the breast care nurse tomorrow, as she gave me her contact number for further use when I was discharged from the clinic,I am noticing under my arm is very tender and swollen in the mornings after elevating my arm during the night,also when my fingers are hanging down in normal position.the swelling returns to fingers,   Thanks Kira for link to sleeping positions although I was doing that anyway,ok until you turn in your sleep on to sore arm ouch.

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Dec 19, 2010 02:34PM scottysue2010 wrote:

Hello folks,have seen a lymphedema nurse at hospital breast unit,she diagnosed lymphedma and fitted me with a sleeve,been back to fracture clinic who disputed this saying it was Complex regional pain syndrome,as I have all the other symptoms of this,discolouration of skin,stiffness in wrist,hand and fingers along with swelling. fluctuating from fingers to arm pit,

Saw my own doctor plus physio who both say it is a combination of both,

Does anyone know if with both these conditions if sleeve is better on or off

 Swelling and stiffness worse when off but skin very tender when on.

Don't want to make either condition worse any advice please.

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Dec 19, 2010 02:44PM mrsnjband wrote:

I would think it would be better to leave the sleeve on.  What about an LE glove?  You might need this as well.  I need one but haven't been able to afford it since my insurance will only pay for 2 garments a year. I learned how to do mannual lymph drainage and this helped as well.  This is my "2 cents" worth.  NJ

Norma June, Bi-lateral MX 2008, Bi-lateral DIEP 2011

Dx 1/10/2008, IBC, <1cm, Stage IIIb, ER-/PR-, HER2-Chemotherapy 01/25/2008 Adriamycin, CytoxanChemotherapy 03/10/2008 TaxolChemotherapy 05/29/2008 TaxotereSurgery 07/10/2008 Mastectomy (Right); Lymph Node Removal (Right); Prophylactic Mastectomy (Left)Radiation Therapy 08/11/2008 ExternalSurgery 08/15/2011 Reconstruction: DIEP flap (Right)Surgery 08/15/2011 Reconstruction: DIEP flap (Left)Surgery 12/12/2011 Reconstruction (Left)
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Dec 19, 2010 03:11PM, edited Aug 20, 2013 06:26AM by kira

Sue, I think you should have a lymphedema glove--not just a sleeve--as any swelling in the hand can be made worse by just a sleeve, without a glove.

If there is a component of lymphedema, then compression is indicated.

Regional pain syndrome is very tough to treat--I don't believe that a compression glove will worsen it, as it is the body's over-reaction to an injury, and edema is part of the syndrome.

I'm in a splint now, and my hand is sore--I'm still doing the OT exercises and seeing her once or twice a week. My lymphedema--present before the fracture--did act up, and I'm wrapping more and wearing day time compression more. Making slow progress.

But, I think you need to have your health care providers give you guidance here: you have two separate issues going on and they need to address both of them.

Since lymphedema swelling can cause pain, I would vote for wearing a compression glove--but it has to be well fitting, and I think you really need your doctors and nurses to give you a comprehensive plan.

Please let us know how you're doing.

Kira

Norma Jean: that is plain outrageous that your insurance won't cover a glove you need--Juzo has just come out with a glove that wholesales at 45$--it's their 1100 line. Recently it was selling at brightlifedirect for 65$. The sizing is simpler than many gloves: small/medium/large/--but you need to have your lymphedema therapist check the fit of any glove you wear. Can you appeal the insurance decision?? You just had cellulitis for goodness sake!

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 19, 2010 03:22PM scottysue2010 wrote:

 Thanks Kira I see physio again on Wednesday,so will ask her about it.

Hope you are coping after your cast coming off.

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Dec 19, 2010 04:02PM kira wrote:

Sue, did they fit you for a glove?

Boy, these fractures sure are hard to recover from. I'm making progress: but have to be patient.

I really hope you don't have much regional pain syndrome--it's a hard thing to deal with--and it does cause swelling, and swelling does cause pain, so it's a vicious cycle.

Sounds like the lymphedema nurse and the fracture center need to get on the same page--but your own doctor and PT seem to understand how two conditions can co-exist.

Amazing how breaking a little bone can cause such havoc.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 20, 2010 04:35PM scottysue2010 wrote:

 Thanks Kira,today has been a nightmare,woke up with very heavy upper arm and armpit ,put on sleeve which covers part of hand with thumb hole,shortly afterwards my arm was frozen felt as if someone was holding a cold air fan on it and very tender and itching,but fingers very stiff and hot.after a while I took it off and it was like a rush of heat and pain from top of arm to fingers,without it after time it becomes heavy stiff and painful goes from hot to cold,as both conditions new to me I'm not sure whats causing what.

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Dec 20, 2010 04:48PM kira wrote:

Sue, it sounds horrible! It does sound like some regional pain syndrome--with the extreme pain, and I wouldn't be surprised if there is lymphedema along with it, as regional pain syndrome causes edema/lymphedema.

Can you see someone to address it?

For those of us who have lymphedema in our hands, we usually wear gloves that cover all the fingers and thumbs.

Please let me know how you make out with the doctors.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 21, 2010 10:30AM scottysue2010 wrote:

Spoke to lymphedema nurse today,she agrees symptoms are of both conditions,she at the moment is not keen on the glove as she says it will cause problems with restricting wrist movement,I have to alternate sleeve on and off depending on which condition is causing most problems,sleeve on for swelling off for tenderness and keep up intensive physio.

 She will reassess in February at next appointment as this will give a better idea to the healing of wrist and pain syndrome. isn't life fun.

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Dec 21, 2010 11:21AM Binney4 wrote:

Sue, for some women with issues of tenderness, they find the night garments (Solaris, JoviPak, etc.) are better for swelling as they're easier to tolerate. Not a bit stylish of courseTongue out, but they're more bearable and also better at reducing swelling rather than just containing it. Do ask your LE nurse about it, since you're dealing with both issues at once.

Your spirit is amazing, by the wayKiss -- you're an inspiration!

Big gentle hugs,
Binney

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Dec 21, 2010 11:42AM kira wrote:

Sue, I have my compression glove on, and it's not restricting my wrist movement at all.

Wearing a sleeve without a glove could push fluid into the hand, so please watch it closely.

The problem with having both conditions is that treating the one, makes the other worse--the compression stimulates the hypersensitivity of the skin.

Sue, here's a Mayo Clinic information on Regional Pain Syndrome--they say it can be prevented with taking vitamin C after a wrist fracture--who knew??

www.mayoclinic.com/health/comp...

You are so patient, I'd be in the LE nurse's office tomorrow demanding Something.

Just in my experience, the compression glove does not inhibit wrist and finger movement.

Hopes for rapid healing from this.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 21, 2010 03:07PM scottysue2010 wrote:

Thank you for link Kira,it was very interesting,I have read a fair bit of the links you have given me,and what I have is a gauntlet which goes from back of hand to shoulder,so it supports the back of hand and arm, I have physio tomorrow so will get her opinion then,have worn it most of today but had to remove it because skin was getting very tender.my main fear is the long term outcome with both,but I suppose only time will tell,the medication they all suggest is what over time I have neen prescribed for neuropathy and although they numb the pain they make me even more dopey than I am making my ballance problems worse,discussed this with my neurologist before and he agreed only to take them if absolutely necessary,

I hope your glove helps with your problems Kira,you are an angel for giving me such good info and advice.