Lunate dislocation in wrist - where else eh?

[bogwoppit]

Bigger Bog has had a lunate dislocation in her wrist for a few months. We haven't seen a doctor yet as that is such a challenge here. The sports physio has put it back in a few times, but now it is out and very painful. BB is away in France for three weeks and can do nothing about it there.

I was curious to see if anyone had experienced this dislocation, and what courses of treatment they followed, and the long term outcomes.

The standard seems to be surgery by a plastic surgeon to pin the bone in place, with casting for a long time. The other seems to be an injection of a liquid to irritate the area and cause tissue to tighten and therefore the bone stays in place.

I would love to hear from anyone who has had this. After the back issue and the following surgery this seems very unfair, but it needs dealing with.

 

[Tumblequeensmom]

Bog, I have no advice for you other than to offer my sympathies!!! No, it's just not fair, is it? I hope she's having a great time in France despite her wrist problem.

 

[bogwoppit]

I called in a few favours today and managed to get her a referral to a surgeon. So I'll be calling the Shriners this week. I should just move in!

 

[gymmomof1]

Wow I have never even heard of that! I will add her again to our injured DDs prayer list. Sending ((hugs)) to you too!

 

[gymmomntc2e6]

Bog, that just plain sucks for bogger bog. after all that with her back, very unfair. wish I had advice, but glad you can get her to shriners.

 

[LMV]

Aww Bog! Your poor daughter is just stuck in this injury trap. Ouch! I’m really sorry!

Ok, things may be a little different in Canada [the scope of practice by field does vary somewhat internationally] but in the US this is more the domain of Orthopedics than Plastics [although it you may see some of the plastics-hand folks jumping in here as well---in the US you can take the ortho or plastics route into the hand surgery fellowship (although our hand guys are never excited about these and like to defer back to ortho even if they are ortho hand some of that is probably politics and just attitude though)]
-Usually when we see this it is trauma related rather than spontaneous
-Concurrent fractures and ligamentous injuries are not uncommon
-Malposition of the bone can compress on the carpal tunnel and impinge on the Median Nerve so there may be acute numbness and tingling from this.
-The bone needs to repositioned. Theoretically this can be done bedside [although I’ve never tried it and I’ve never seen Ortho try it]. Usually the sense is that even if you can get everything repositioned it will be too unstable to heal without some surgical stabilization [additionally if there are concurrent injuries they need to be addressed] so in my experience these patients go to the OR and end up with external pins for stabilization to allow everything to heal.
-There is urgency to addressing this because the risk of complications does increase with delayed interventions.
-Yes, post op healing/ rehab is long. Usually patients are quoted around six months if things go well.

Good luck with this and everything! Hang in there!

 

[Tumblequeensmom]

After reading LMV's post... poor Bigger bog!

 

[coachmolly]

Poor girl! She just can't seem to catch a break. I hope she's managing to have a great time in France despite the pain and that things can be taken care of once she gets back. Here's to hoping it's not as severe or the recovery not as time consuming as originally thought. My thoughts and prayers will be with her. Have you invested in the bubble wrap industry yet

 

[bogwoppit]

Thanks guys, she is having a blast in France and the parents there are taking very good care of her. I have learned that she is not built for many sports, too late really, but I have learned.

LMV, thanks for that info. I tis as I suspected. We have no knowledge of any one incident or fall. SHe has had wrist pain on and off for a long time, done physio etc. The disclocation appeared from nowhere, it seemed. We went to the sports therapist, who I think steered us wrong. She put it back in, but as I see it just cannot stay in place due to the ligament issue. LMV you confirm all that I thought.

The long term effects of doing nothing to fix the issue, effectively, bother me more than anything. However she is away until the 23rd Aug. I will have a refferal today and I will call the SHriners in the morning to ask if they can see her asap. THey are close-ish, by our standards and have some great ortho docs, it is also where she had her fusion done.

If this can be dealt with quickly her recovery time should fit well with her fusion recovery time. The question is, how much of an emergency is this where we live. The health care wheels turn VERY slowly here.

 

[Deleted member D3987]

surgery is the only permanent fix. if you're comfortable with this, this is what some of us do short term to reduce the dislocation so that the nerve doesn't get permanently damaged.

1. someone grabs her hand and in a "handshake" position and holds firmly with the thumb knuckle up.

2. the subject (your daughter) slowly pulls her arm away from the wrist.

3. subject slowly rotates her arm clockwise and then counter clockwise. back and forth. slowly. she will then feel the bone 'slip' back in to position.

this may sound a bit radical but it works as long as it is done slowly.

 

[bogwoppit]

I shall send her that Dunno, she can decide if she is brave enough. The physio did show her how to help it back in, but she says it hurts a lot when she pulls on it.

I am awaiting a call from the nurse at the Shriners, it looks like they will see her when she gets back. I am glad she is enjoying France, but right now I wish she was home so I could get this thing dealt with.

This kids deserves a medal!

 

[bogwoppit]

Talked to the great nurse at the Shriners, BB can see a specialist on the 27th September, so we will have to rest, ice and advil until then. Seems like a long wait, even by Canadian standards, but at least I have a date. Hopefully they can work out a treatment plan and get onto healing fast.

 

[Deleted member D3987]

make that 2 medals...