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Q. Experiencing numbness and pain after elbow fracture treatment. Why?

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 19, 2016 and last reviewed on: Jan 31, 2020

Hi doctor,

I had elbow fracture four years ago. Following which I have limited ROM and stiffness. Now, I am also experiencing numbness, tingling and pain in palm and fingers. Why?

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#

Hi,

Welcome to icliniq.com.

  • You have mentioned that you sustained elbow fracture four years ago. Can you kindly furnish me information that what fracture was it actually and what management was done in your case at that time?
  • Also, I would like to see,
  1. Latest clinical pictures of your elbow showing the range of motion (ROM).
  2. X-ray of the affected elbow (AP - anteroposterior and lateral views).
  3. Your previous treatment papers by which I can understand your injury details and other things.
  • Also, tingling and numbness actually indicates that there is a nerve involvement and management of which can be decided if I can have a clinical examination and nerve conduction study of the affected upper limb.
  • Kindly furnish me all the details so that I can see and then advise you accordingly.

Revert back with detailed history to an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Hi doctor,

I had a fall from two wheeler on out stretched arm four years ago. The doctor took x-ray and said it was partial radial head fracture. I was in cast for three weeks. After cast removal, I was prescribed active exercise to regain full movement. Ten days after cast removal, I went back to the doctor. I had not regained full movement, so physiotherapy was recommended. The first few sessions of therapy were very painful and I lost the movement that I had before. I took a week break and started physio again. Next eight months I did everything I was asked to do for regaining movement including using heat modalities like hot water, heating pad and bee wax, active exercises and passive. The therapist could fully extend and flex my hand to touch my shoulder. But, it was increasingly painful and my hand got more stiff. After nine months, I went back to the doctor. As per his recommendation I got a CT scan done which showed inflammation of joint. Immediately, I was asked to stop all physiotherapy and only do active exercise. I have not got a measurement of ROM. My full flexion would make a 90 degree angle and extension would be 120. I might have about 30 degree play in the joint. No pain or discomfort and I am able to lift weights. Because of limitation in flexion, I experience difficulty in eating with right hand, combing, wearing ear rings and cannot use the right hand to talk on phone. I have learnt to live with these limitations. Last couple of days, I am experiencing numbness and pain in the palm and fingers. Mostly early morning and sometimes during the day. I have attached all the reports given by my doctor and scan taken nine months after trauma and another scan taken last year. Please help.

#

Hi,

Welcome back to icliniq.com.

  • I have gone through all the details which you have sent me (attachment removed to protect patient identity) regarding initial diagnosis and management done and the CT scan reports.
  • As far as I am concerned I am not able to understand about your range of movements. Also, CT scan reports are very confusing because it shows multiple fractures and not only a radial head fracture.
  • Please send me the pictures taken from a camera showing your full extension, full flexion, full pronation and supination. You can get them clicked by visiting a physical therapist and this will also enable me to understand your affected elbow range of movements.
  • What I can understand right now is that there is only 30 degrees ROM that is from 90 deg flexion to 120 extension which is extremely less especially if this is your dominant hand.
  • Also, kindly get a latest digital x-ray elbow anteroposterior and lateral views, so that I can see what is there with the bony architecture.
  • Anyways to brief you that if there is only a 30 degree ROM, that is clearly not sufficient and we will have to look at surgical arthrolysis or opening up the joint so that your ROM can be increased. As it has been four years since your injury, physical therapy alone will not help.

The Probable causes:

Injury four years back.

Investigations to be done:

1. ROM charting with physical therapist.
2. X-ray of the affected elbow.

Differential diagnosis:

Intra-articular loose body.

Regarding follow up:

Revert back with the photos and x-ray to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


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