Re: Thinking Cap

Author Subject: Re: Thinking Cap
Brian Robinson Posted At 01:01:33 05/03/2001
In September, 1999 I sustained a left distal radius intra-articular fracture with significant comminution as well as dislocation of the distal radial ulnar joint (Galeazzi). An ao pi plate was utilized to internal fixate the fracture, and synthetic bone graft was utilized to reconstruct the radius. I also have a loss of radial length and incline with a corresponding ulnar variance. This past this past January, 2001 I had the ao pi plate removed in an attempt to resolve my pain.

After 19 months my pain is essentially unchanged. My chief complaint is the tremendous pain on the dorsum of the wrist with both dorsiflexion and palmar flexion. I also experience a "stabbing" type pain with supination and ulnar deviation, and still have a tremendous amount of baseline pain even when it is immobilized. My strength and range of motion are 80% of my uninvolved wrist, although it is not a fluid, pain free type of motion, and I still have a great deal of stiffness. My nerve conduction studies are normal, my radius has healed with a reasonably straight radial carpal surface, but with incongruity in the sigmoid fossa. And I have had nerve blocks that seem to have ruled out RSD.

The bottom line is that this injury has destroyed my quality of life, and I have become nearly housebound due to the pain. I have consulted with highly regarded physicians, including Julio Tuleznik (sp?), Dr. David Green in San Antonio and Dr. Amit Gupta in Louisville as well as local surgeons. Many options have been discussed including ulnar shortening, radial osteotomy/lenthening, denervation, radial chelectomy (sp?), fusion, etc.

1) Are there other surgeons on the "cutting edge" for this type of problem I should consult with?

2) What procedures would you recommend in this situation?

3) What are the risks of the procedures mentioned above?

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