why would the doctor tell me this....?

Question

i broke my wrist and had surgery on it friday. i am going for a cast on tuesday but the doc told me after my surgery that i cant use my arm for 6 weeks. so i understand that i cant use it now, because i am in a sling and splint, but why after i get the cast wont i be able to write? or drive? shouldnt the cast hold it in place enough that i can semi use it?

Answer 1

First of all... there are NOT 30 bones in the wrist. There are 8. These are called carpal bones. They support 5 metacarpals which comprise the bones of the palmar hand. These, in turn, support the 14 phalanges, the segmental bones of the digits. There are 3 in each finger except the thumb, which has two.

Unfortunately, your question doesn't give enough information for me to be completely useful to you. However, there are a few things you should probably know, and this much I *CAN* say...

One of the common misconceptions about casting is that it immobilizes the bony structures. This is just not true. It does a reasonable job at fixating the gross position of the structures inside the cast, but movement of the joints still happen, and movements of the fracture fragments still happen. If movement absolutely cannot be tolerated, then orthopedic surgeons fixate the fragments together with metal fixtures, plates, screws, or rods.

Bone is living tissue and requires blood flow just like every other part of the body. Bone is surprisingly active tissue in terms of it's requirement for blood flow. Most people just imagine that bone is like the steel beams in a building, but nothing could be further from the truth! If bone is robbed of it's blood supply, it dies. If it dies, it does not grow back. It rots in place. This is a devastating complication when it happens, and it DOES happen.

One of the more common fractures of the wrist is in a bone named the "scaphoid" or "navicular" bone (both names relate to the shape of a boat). The scaphoid bone is deep in the wrist at the base of the thumb. This bone is particularly vulnerable to a common injury mechanism called "Fall On Out-Stretched Hand" or "FOOSH" for short. FOOSH tends to concentrate force on the heel of the hand and breaks the scaphoid bone.

Scaphoid fractures are unfortunate because of the interesting way in which the blood supply to the scaphoid is routed. The wrist joint has smooth cartilage on all its surfaces, so that wouldn't be a good place to route the blood vessel. Instead, the artery to the scaphoid bone has to cross the wrist joint and then come back in a J-hook shape before it enters the bone. This means that the side farther from the wrist gets the blood first, and after that it trickles back toward the closer end.

When the scaphoid bone is broken, it unfortunately cracks in half in a way that robs the fragment closer to the wrist joint of its blood supply. The fracture fragment farther away from the wrist is actually well supplied with blood. The closer half is in jeopardy. If the fracture is displaced enough, the closer fragment will die of insufficient blood supply. This is called "aseptic bone necrosis". It can make a relatively minor injury into an ongoing problem which causes pain and disability for the rest of someone's life.

My wild guess is that you've fallen on an outstretched hand and cracked your scaphoid bone. The break is bad enough that they opted to bring the fragments back together with surgical pinning. Now they are worried about the blood supply. As long as you don't tend to pry apart the fracture fragments, the blood flow will probably trickle across the fracture and feed the starving pieces. If you move the fracture fragments, you may destroy parts of the healing bone.

I hope that scares you enough to comply with your surgeon's recommendations!

Answer 2

Your doctor wouldn't be able to tell just by looking if you have or have not been fingered. The only evidence there should be to that extent is the bodily fluids released during female ejaculation. As long as those fluids are not present at the time of the examination, you should be ok. if you are under the age of 16, the doctor would probably tell your parents about any sexual activity. Over that age, the doctor will probably just assume that you and your parent have talked about it and it is already known. This could lead to other problems though. Your doctor could make a general statement about your sexual activity in front of your parent(s) and then you would be caught. But no, they won't be able to tell if you have been fingered. They will ask you if you are sexually active, and if you say yes, they usually tell you about condoms. They don't make it a point to tell your parents or lecture you about it they just want to promote healthy lifestyles. Keep in mind that if the doctor is fairly close with you and your family it could play a role in whether or not they tell your parents. If the doctor is rather close to your family, maybe you should keep your business to yourself.

Answer 3

The cast will help you hold it in place but if you are moving your fingers then there are tendons and bones in your wrist that are moving too. For your fingers to move your arm muscles must contract and those tendons run right through your wrist. So to prevent further inflammation and damage I would work as hard as possible to use your arm as little as possible. If it doesn't heal right then you might never have complete use of your wrist/hand again and that isn't something worth risking.

Answer 4

The wrist is made up of a lot of small bones. Moving it slightly could do a lot more damage than you might think by looking at it. Also, there are quite a few tendons and ligaments that could be damaged as well. You're best off going with what the doctor said, it'll heal much quicker that way.

Answer 5

No. The bones will move inside your skin. There are like 30 wrist bones. The cast only prevents your arm/wrist from moving. Your fingers moving when trying to write can aggravate the wrist.

Learn to write with the other hand. That's what everyone with a broken wrist/hand has to do.

Answer 6

Just obey. My daughter worked for a hand surgeon who did delicate wrist work and the most common cause of complications was impatience...

In terms of muscles and nerves this is a very concentrated area.

the wrist is the flexible and narrower connection between the forearm and the hand. The wrist is essentially a double row of small short bones, called carpals, intertwined to form a malleable hinge. The wrist-joint is a condyloid articulation allowing three degrees of freedom.

http://en.wikipedia.org/wiki/Wrist

Just don't push it. You will know when you can push it a bit. this is too soon. But you will know.

Answer 7

Just do as the doc says. you could get hurt worst if you do not.

Answer 8

try driving with the cast see what happens(dont really do that).

Answer 9

Best thing I can tell you is...better listen to bellydoc. He's the professional.