risk of lymphedema after wrist fracture

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.

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

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.)

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.

http://www.eatonhand.com/hw/hw020.htm

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

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 

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!

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

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

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 course, 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 way -- you're an inspiration!

Big gentle hugs,
Binney