distal radius fracture and non-surgical 'C-Trac'
I am having severe CTS debilitation in my left arm/hand and loss of feelings, grip and weakness. It is 15 months since I was injured getting into a parked car as my left arm was crushed and trapped by another car rear reversing. The pain is going up my arm into my shoulder and neck. I am not getting sleep at night this has brought on hypertension. I did not have high blood pressure before this and suffering from flashbacks from the incident causing problems with me travelling as a passenger. I am attending a physiotherapist for treatment privately as the hand specialist wrote me off and told me to purchase therapy putty online. I have a bit of abnormality showing on the wrist bone unfortunately as the manulapition of the fracture was mislined and the wrist shows signs of thickening/swelling. My thumb was particular unbearable while in the cast and nothing took the edge of the pain particulary at night and I didnt sleep.
I have considered the CTS release and decided it might work for a while at least and I would have more scarring tissue giving problems especialy in the cold weather and then I would require a further release. I would like an alternative non-surgical treatment and I have seen this is available from a US company.
I am considering the 'c-trac' trials but I understand I must be referred by a health professional to get considered.
I was dignosed with CTS by Orthopaedic Consultant Mr A. Foster from Alnagelvin Hospital Londonderry N Ireland who wishes to persue a CTS release by surgery. At my own expense I requested a dignostic nerve conduction which I am having carried out Tuesday 6th February by Doctor Kiang An Pang Clinical Neurophysiology who is an NHS Doctor of medicine at the Royal Victoria Hospital Belfast. I am speaking to him re; the 'c-trac' device and asking for a copy of my conduction test.
I can no longer safely drive my manual transmission motor becasue of the loss of feelings and poor grip. I can no longer lift and nurse my grand child or do numerous activities like sewing, art and design. I write with my right hand but i am ambidextrous with other things.
Sorry for the rant but I only have two arms and one of them is in a bad way and I am fighting for it and your help would be appreciated to try this 'c-trac' trial device.
regards Jean
Thank-you JB for your frank response on CTS it is appreciated. I will get my full report on the nerve conduction test in four days but Dr Pang has stated that the median nerve test on my left arm is severe, and I was shocked when he stated I had a tinge on the right arm. I had'nt noticed anything I wasnt bothered or inhibited by this whatsoever.
Dr Pang recommends a CPS release out patient procedure, immediately and I am pondering my options and would like your advice JB. Is key hole surgery better with recovery time shorter and the wound size small?. Also JB I am worried that CTS release might help perhaps a while then start giving trouble after a few months. Or it might make my pain worse as I have heard reports about this being the case. I have some abnormality on my wrist since the fracture due to the mislined distal radius bone and this has left a gap and tightned the CT. JB will this gap and abnormality get worse when I resume activities and may need further surgery if that is the cast. Any pros or cons that you can offer to help me decide would be good as I could make an informed decision better when I know more information. Regards Jean
It's quite common to find early evidence of CTS on the other side when testing someone who has developed symptoms after a wrist fracture, so no surprises there.
I'll reserve judgement on treatment options until after we see the NCS results ('severe' does not really mean a lot I'm afraid) but there's not much to choose between traditional open and 'keyhole' surgery - the end results are the same anyway and the difference in recovery time is trivial. Surgery is usually pretty all-or-nothing. It either works very well for a long time, or doesn't work and leaves you worse off than before you started. True recurrences of CTS after surgery usually take 20 years or so.
I don't think there is any real evidence to say that treating CTS after a wrist fracture is fundamentally any different to treating it in a pristine wrist.
There is a little evidence to suggest that problems after surgery are more common in those who go back quickly to very heavy manual occupations so if you normally spend all day with a chainsaw chopping down trees or a jackhammer digging roads then you might expect difficulties. Less extreme occupations are not generally a problem. JB
Thank - you for your JB it is most appreciated. I have my results but I cannot understand it and would like your assistance, you were correct about severe meaning little or nothing really. Please tell me what figures I need for you to clarify my position. I can post a copy as well if you require as I am unhappy indeed as he states I propably had carpal tunnel syndrome pre-existing in both hands before the fracture and if I did I didnt know and it did'nt leave me unsafe to drive. I will wait to hear from you as what steps to take regards Jean.
The easiest thing to do is email me a copy of the report. If you can't scan it you can just photograph it with the phone nowadays and email - it will usually be legible. I agree with your doctor entirely - I think most people who get CTS after a wrist fracture were destined to get it anyway. The trauma of the fracture just makes it present earlier. One of these days I'll do the statistics on it from my own database - another study that I don't really have time to do :-( JB
Sorry JB I tried a few times to reply to your email and attach the nerve conduction test as I cannot attach a file here, if as I suspect did not receive it please send another direct link I have the file scaned in my folder many thanks Jean
Safely received by email and I've replied that way too as it's a very specific set of comments. JB
Thank-you kindly for the interesting reply which I will bear in mind. I will let you know how the carpal solutions experiment goes.
Regards Jean McLernon
There is currently no high quality evidence to support the use of the 'c-trac' device. We were considering a trial but I'm afraid we could not get this working. In any case, I would not make decisions about how to treat your problem until you see the nerve conduction results. You should ask the doctor carrying the tests out for a copy of the results, and to grade them using one of the published severity scales, rather than using vague words like 'mild' or whatever. I'm afraid I do not know much about the Belfast Hospitals neurophysiology service - there are three members of the British Society for Clinical Neurophysiology whose names are linked to Belfast but none of them match Dr Pang. Once we know how much of a problem there is with your median nerve I'm happy to discuss the pros and cons of different treatments so that you can make a well informed decision. JB