What's wrong with my WRIST???
Complaint: Wrist hurts/feels funny (numbness/pinching when idle, pain when extending the elbow).
Background: I have an impacted radial head fracture. My insurance from my job didn't happen like it was supposed to.
Male in good health - Mountain bike accident – I landed pretty flat on my front: knocked the wind out of myself, bad R knee contusion through armor, bad R pelvis contusion, and L hand impact causing L arm injury. Apparently, looking at the thumbnail sized avulsion on the palm, I struck the palm of the hand in the landing. That was the only sign of injury on the L arm… except of course for the swollen elbow.
Immediate symptoms:
Severe elbow pain on extension and suppination.
Wrist pain for 3-4 hours after injury.
I splinted it and made a sling and took a lot of Aleve.
ER x-rayed the elbow, but decided not to x-ray the wrist.
Dx: X-ray showed possible impacted radial head fracture.
Rx: Sling, ice, referral.
Saw Orthopedist at 5 days post injury. He examined the wrist and elbow (which hadn't hurt since the first day) and decided not to x-ray anything.
Dx: He confirmed impacted radial head fx and partial interossous membrane tear.
Rx: sling for 2 weeks, no strenuous activity for 4 weeks, immediate PT on the elbow
I still typed with my left hand after the first week. After 2 weeks, I was mostly pain free except at the extreme ranges of motion caused some pain midshaft on the forearm (membrane I think). Strong hand grip also caused the midshaft pain. Elbow extension (still a few degrees short of anatomical) caused temporary tingling in the index and thumb down to the wrist.
I removed the sling and swath. My activities were limited to normal daily activities like driving, eating, typing, and taking the elbow through its range of motion. After a day or two without the sling, I started to notice some minor irritation around the radial part of the wrist.
I went to PT at 16 days. PT was impressed with elbow ROM and did some exercises (elbow flexion, extension, suppination, pronation) after which point my wrist started to hurt. She examined the wrist and didn't think it was a big deal. She contacted the orthopedist anyways. Apparently, he didn't think much either.
Now: 17-22 days post impact
At idle:
There is an area of decreased sensation the size of half my thumb right over where you would take a radial pulse.
Palpation will produce minor soreness midline on the palm right at the most proximal point of the fleshy part.
It feels like a very slight pinch at the crease in the wrist, palm side, between the midline and thumb.
The problems around the wrist are exacerbated greatly to the point of pain when doing elbow extension exercises. The idle symptoms are stronger too and last for a few hours. Elbow pronation bothers it only a little bit (ie accompanying full thumb flexion produces soreness midline proximal palm).
Elbow flexion and suppination do not cause problems. Using the hand and wrist doesn't really seem to bother it either. Wrist/hand strength and wrist/hand ROM are 100%. Nothing feels funny during motion.
What's wrong with my wrist? Is this a ligament, tendon, or bone? Does having an impacted radius mean that the bone is shortened such that it is pulling on the wrist joints?