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Distal Radius Fracture: Adding Daily Deep Oscillation To The Healing Process

This article describes the injury, surgery and treatment for a distal radius fracture, with adjunctive self care utilising Deep Oscillation therapy during national COVID lockdown number three for 31 days. Fracture of the distal radius is a common clinical problem, particularly in older people with osteoporosis.

Background

Mrs N is 68 years of age, of slim build and leads a very active life. She looks after many animals, including cats, dogs and has a real affinity for our feathered friends.  

She was diagnosed with Osteoporosis in 2011; a health condition that weakens bones, making them fragile and more likely to break, which develops slowly over several years and which is often only diagnosed when a fall or sudden impact causes a bone to break. Prior to the current injury, Mrs N had broken the same wrist in 1984.

She also has Hypercalcaemia; a condition in which the calcium level in blood is above normal. We know that too much calcium in blood can weaken bones, create kidney stones, and interfere with how the heart and brain work.

Mrs N also suffers with Irritable bowel syndrome (IBS), a common disorder of the digestive system and has Coeliac disease, a condition where the immune system attacks its own tissues if gluten is consumed, the condition stops the body from taking in nutrients.

 

Diary of Events

During a period of heavy snow fall in Winter 2021, Mrs N bent to stroke a neighbours pet and lost her footing, falling to the pavement and landing heavily on her left (non dominant) wrist. An x-ray at A&E was carried out (below) and diagnosis of distal radius fracture was made, with a break in two places

 

25th January 2021 - Mrs N revisited the clinic for 20 mins of traction, followed by manipulation for 10 minutes by two doctors and a new cast was applied.

 

2nd February 2021 - Mrs N returned to clinic, the cast had become loose; a further x-ray indicated that surgery was required and Mrs N re-attended the following day for a fixation with regional anaesthesia (RA).

 

 

16th February 2021: photo shows a very tight, raised extended radial incision, swelling of the fingers, the web and palm of the hand and the thenar eminence of the thumb, extending up the arm particularly on the lateral aspect towards the elbow

 

 

24th February 2021 - Pre Deep Oscillation Treatment 

Photo shows little change in the raised reddened tight scar and the arm is still significantly swollen

 

 

29th March 2021 - Post 31 days of Daily Deep Oscillation

Photo shows a remarkably positive change overall in the lower forearm. The incisional wound is significantly flattened, skin creases are apparent along the whole of the scar and in abundance at the wrist. There is clear evidence of venous drainage which was not evident on February 16th and barely so on February 24th plus, the arm is noticeably much less swollen with a greater hand, wrist, arm definition.

 

 

DEEP OSCILLATION PERSONAL UNIT HIRED FROM PHYSIOPOD 

Preprogrammed indication: Osteosynthesis

170 Hz to 200 Hz  for 15 minutes, 60 Hz to 100 Hz 10 mins

Aim of Deep Oscillation:

Pain and swelling reduction, calming effect, providing an earlier return of blood oxygen and nutrients to injured area, resulting in a dynamic wound healing with smoother and less scar tissue, promoting an earlier return to normal activities.

Patient Feedback

In January 2021, I slipped in the snow and broke my wrist in two places, after two weeks in a cast it was obvious I needed an operation to have a plate put in it, I was unable to do anything with it for a number of weeks and had quite an ugly wound and an extreme amount of swelling and bruising that went as far as my elbow. I was offered the use of a physiomed deep oscillation machine from Physiopod, and contraindications checked, I began a months loan.

The relief was incredible.

The swelling quickly reduced and the bruising faded but the biggest surprise was how quickly the scar mended, on my last appointment to the hospital both the Doctor and the Physiotherapist commented on how well my wound was doing and asked me if I’d been massaging it, needless to say I told them exactly what I had been doing and they were very impressed.

In terms of movement, I can't bend it forward as much as it did before but apart from that small thing I have all my movement back.  I was also very compliant with the strengthening exercises I was given to perform and followed all of their advice. I took paracetamol for a few weeks and a few Ibuprofen for the first couple or days. I had 2 codeine the day after the operation and I used Bio oil twice a day.

Thank you PhysioPod 

 

With thanks to Christine Talbot, Lymphoedema and Bowen Practitioner for additional photo narration on healing process and scarring.

 

 

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Distal Radius Fracture Healing Enhanced with Deep Oscillation