Distal Radius FRX - 4 months healed - What does my MRI mean?

[FireLikeIYA]

Hello,

Any help is greatly appreciated! Sorry, long intro.

About my injury:
I am going to describe this the best I can. I am currently recovery from a comminuted intra articular distal radius fracture. There is only one fracture across the articular surface of the radial bone. I am 4.5 months into recovery of the fracture which had an approx 2 mm gap and has an approx 1 mm step off. The fracture is located in the articular surface of the radius towards the thumb side just where the radius starts to arc upwards. The fracture travels straight from the back of my wrist to the palm side of my wrist. Looking at the x-ray, which was taken palm down, it appears the step off is at the dorsal side of the wrist. In other words, the step off gradually starts from the back side of the radial bone at 0mm to the dorsal side of the radial bone at ~1.5 mm. Surgery was not performed. Sorry, a picture would be better.

The reason for my concern:
I recently had an Arthrogram MRI done due to a suspicion from my Orthopedic surgeon that I had a scapholunate ligament tear. My Orthopedic Surgeon went over the results with me this past Tuesday andinformed me that all of my ligaments look good. He also told me that there was some bad news. He informed me that I had chondromalacia in the joint. He said I am only the second patient of his to ever have an MRI 3-4 months after an injury so hedoesn’t have a lot to go on with what to expect or what this really means at this point. This is what was shown on the MRI report:

"There has been interval healing of the previously demonstrated comminuted intraarticular fracture of the distal radial metaphysis. Subtle irregularity along the central to dorsal radial articular surface remains with overlying grade 2-early grade 3 chondromalacia in this region with grade 2 chondral changes also evident along the proximal scaphoid pole. There is a type II lunate without MRI changes to suggest harmatolunate impingement. Ulnar variance is grossly neutral."

The reason for my post is that I am no longer seeing my orthopedic surgeon as he considers my wrist healed. He told me that in his opinion I should not have any problems until I reach 50. I am 33 years old and active. I have a specialized job that sometimes requires physical labor. Can someone tell me what my MRI means and if I should be alarmed? Again, my doctor informed me that he was unable to tell me how he should interpret it as it was only the second MRI he has seen this soon after an injury and he didnt know if it was normal to expect it. Should I seek a wrist/hand specialist? Thank you!

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[zickey marya]

hi there FireLikeIYA....
how are ya?

see first of all, forget that it`ll affect u at the age of 50 or so...

Chondromalacia often strikes young, otherwise healthy, athletic individuals only...

if ur doc said so, forget the doctor, maybe his experience is less, or maybe he is confused.

u said that the affected part is wrist, so try keeping these things in mind...

1) DO NOT immobilise ur wrist for long, u may go for stiff wrist...
2) DO NOT overuse it also, as it may further deteriorate the condition...
3) strenthen ur muscles, mostly ur forearm and wrist covering muscles so that they make counteract as ur helping aids for the joint condition...
4) go to a different doctor, a wrist specialist if u can...
5) have a sustained , prolonged , and not at all aggressive physical therapy, including NMES...

u should be alarmed but not that much because this condition is almost affecting every young , athletic active individual these days...

any further questions are welcomed...

Zickey Marya
wellness works!!!

[FireLikeIYA]

hi there FireLikeIYA....
how are ya?

see first of all, forget that it`ll affect u at the age of 50 or so...

Chondromalacia often strikes young, otherwise healthy, athletic individuals only...

if ur doc said so, forget the doctor, maybe his experience is less, or maybe he is confused.

u said that the affected part is wrist, so try keeping these things in mind...

1) DO NOT immobilise ur wrist for long, u may go for stiff wrist...
2) DO NOT overuse it also, as it may further deteriorate the condition...
3) strenthen ur muscles, mostly ur forearm and wrist covering muscles so that they make counteract as ur helping aids for the joint condition...
4) go to a different doctor, a wrist specialist if u can...
5) have a sustained , prolonged , and not at all aggressive physical therapy, including NMES...

u should be alarmed but not that much because this condition is almost affecting every young , athletic active individual these days...

any further questions are welcomed...

Zickey Marya
wellness works!!!

So is it possible that the chrondomalacia will go away? I currently do not use a brace but I have one. Should I bother sleeping in it or wearing it during the day? I feel a numbing sensation in my wrist but I am not sure if that is from the chrondomalacia or if my wrist is still aching from being broken.

[zickey marya]

see, if you want to rid yourself of chondromalacia, you MUST rest.
Any activity that causes pain is causing further irritation to the cartilage.
Without specific exercises to balance these muscles, and a proper stretching routine, the problem of chondromalacia will likely not be solved. Doing the exercises every day is an important part of treatment.
You need several weeks, at a minimum, to allow the irritated cartilage to settle down. You'll then need several more weeks to slowly build up your activities in order to resume your normal schedule.

using a brace is good, but NEVER EVER EVER EVER, wear it and sleep!!!!!
u can wear it and forget it in the day time when u are awake, but dont do it in the night time when u are sleeping.

reason for the numbing sensation may be many, so lets not worry abt that now. it`ll give way as and wen u start doin` regular exercises...

tell me, wot exactly is ur field of work? that is also a very important info....

hope to hear from u soon...

tell me if u need any exercises or some...

Zickey Marya
wellness works!!!

[FireLikeIYA]

I have learned a few exercises from the physical therapist that I was seeing that I believe was more geared to increasing my range of motion. There were a couple of strength training exercises that involved a type of play-dough. Some of these exercises did cause a soreness in my wrist so I am not sure if they are all beneficial. My physical therapist was unaware that I had chondromalacia when she assigned the exercises to me but she has 20 years experience so I imagine that she had an idea to the extent of damage to my cartilage. I am no longer seeing the physical therapist as my doctor did not renew my prescription for physical therapy and it is quite expensive without being able to use my insurance. Should I continue on with the exercises that did not cause my wrist to go sore that I was doing with my therapist? I could scan the example sheet she gave me and post it on here to show what I was doing. If you could recommend some exercises for me to do I would appreciate it. Currently I do basic range of motion stretches once a day on my wrist.

I am trying my best not to do anything extensive with my wrist. I am confused with what I can and cannot do at this point in time. My doctor informed me that I am OK to do whatever activities I wish to do. With that response I asked him if I could dig an 8 inch deep 50 foot trench in my backyard to put in a small irrigation line. His response was to maybe hold off for a while which contradicts his statement that I am OK to do whatever I want now. I do pick up my daughter (approx 30 lbs) to hold her which takes both hands but that is the extent of what I currently do. As far as my job goes, I am a power plant operator. To be more specific, I am a control room operator. My job mainly involves operating the plant via computers, however, I also get cycled to work as an outside operator which involves operating large manual valves, transferring chemicals, lifting, etc. Luckily, I am training a new operator so I am not scheduled to work outside until Dec.
Additional Comment I forgot:
I wish I would have read your post sooner. I did wear my brace one night and it made my wrist very stiff. I had some burning sensations on the thumb side of my wrist while trying to get my range of motion back from this.

Would it help if I scanned a few images from my MRI and post them on here? I do not know how to read them but I have a strong feeling as to which images show the chondromalacia.

So chondromalacia is a softening of the cartilage along with surface damage? The softening of the cartilage is due to the fiber network in the cartilage breaking up... Is this a true understanding of what chondromalacia is? Does the fiber network restore itself as to allow the cartilage to regain its resiliency to being wore down?

[zickey marya]

sorry for the delay for all these days first , man...

was stucked in my field....

first of all, lets go step by step.....

1) if u can show me the mri report and the scans , i`ll readily tell u abt the same as to what extent is ur cartillage damaged...

2)talkin` about ur previous physio, lets just keep her out of scene. u should understandthat PEOPLE MAKE MISTAKES...

3)dough-pitching is good, but do not go on the harder side. do it until the dough gets a little hard on u, not after that. after i see ur MRI , then we`ll see abt the next line of work...

4) ur first work is to keep off the hard work, apply ur brace in day time as long as possible, keep recruiting ur junior worker and handle him some of ur hard work.

5) now its not softening, its WEAR AND TEAR, chondomalacia that is..

6) lets count deeds that u have to do.....

a) wear Brace , but in day
b) less Load, on the wrist
c) Rest is the key, for the hand
d) Stretch ur muscles, from forearm to fingertips
e) Eat as much green vegetables, low calorie fruits, etc.
f) try Walking, twice a day. start from 200 metres , then stretch as far as 1000 metres. then thats it! remember, u dont have to overdo it!!!!

keep this code in mind,

B - BROTHER
L - LUTHER
R - RAN
S - SANG and
E - EDUCATED the
W - WORLD


its a bit lame, i know...

but memorise it...

hope to hear from u soon!!!!

zickey marya
wellness works!!!