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Experiences with Ulnar Shortening Osteotomy
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Hello everyone. I don't mountain climb but I am right along with you guys in pain of the wrist. I had a fall back in 2016 and that fall agitated the wrist. In 2016 and even up till now I suffer with pain everyday. I first had cortisdone injections in both wrist and then wearing a cast and praying that that would help. However, after right back to where I started from. I was using pain creams and tylenol and Ibprofen and everything you can think of. Then as time went by I had the UOS and had the cast and everything and now I'm in pain all over again. In two more months I will be having the plate removed and I will face the fact that this is it. Pain pills and cream everyday. God bless us all. |
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2 month post-op update: |
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So where shall I begin. I fell about 2 years ago and I tore my tfcc had it repaired. My doctor at that time said my ulnar bone was in the positive but he didn’t want to touch that yet to see how I would do with this repair. In about six months I started having pain again. I went to a hand specialist and he said I can guarantee you tore everything again.... and I did. He then said if I started to have pain again we most likely will have to shorten the ulnar bone. Then covid hit .... pain is coming back. Then July 20 I go in for the surgery. That was painful I’m not gonna lie. First x Ray everything looks great looks nice and lined up. One month later looks like it hasn’t healed yet space is starting to get bigger. Every month the space has gotten bigger . I am going on 7 month and guess what I have a non union. Currently my elbow is killing me also. I got a nice ball starting forming and hurtful to the touch. I’m ready to cut my arm off |
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Hi Everyone, I must say I'm a bit freaked out. I got my tfcc debridement and USO 14 days ago and am still in a tonne of pain. I read so many different post surgical physio stories where people are using arm and hand soon after but I'm being told to rest it for 6 weeks post surgery. And dumb me I thought it wouldn't be so bad I booked a backcountry hut to ski into in April. The last 3 days my lower base of elbow is killing me. Any stories on healing? I hope this is just a hill to get over then healing speeds up. Doctors aren't saying anything. Thanks! Cheryl |
Lucas Hamilton B wrote: 2 month post-op update: hi Lucas! Do you have an update? I'd love to hear about your healing experience. Thanks, Cheryl |
Cheryl Lowe wrote: Hey Cheryl, I might as well revive this thread with a long overdue update. TLDR at the bottom. It's now been over a year since the surgery (Nov. 1st, 2019). I was initially told that the recovery period would take about 1-2 months before I could start climbing again. Unfortunately, I had a non-union complication; that is the site of osteotomy would not heal and both sides of my ulnar would refuse to join. Having read some papers about it beforehand, I knew this was a potential complication, but I had none of the comorbidities (active, non-smoker, reg. weight). I got unlucky, and it sucks. So no climbing for me through the winter at all, instead, very light physio and was told to get an Exogen by Bioventus ultrasound device for low-intensity pulsating ultrasound (LIPUS). Used it 20mins a day, every day, without fail, for 3 months. By the time May came around and climbing season had started, my fracture was still completely open; however, early signs of healing were starting to creep up (a soft callus had formed, which is a better sign than nothing at all). I did a lot of "pushing" exercises (such as gradually ramping up pushups) at first, with the logic being to put pressure through the ulnar in hopes of actively closing the fracture a bit, and recruiting some muscles and keeping the region active without going into pain. - I started climbing outdoors in late May again despite the non-union. Very slowly. All sub-5.10, never put myself in a position where I really had to pull, and my wrist was not really a problem/limiting factor. At the same time, I ramped up physio to include mobility exercises, spatial awareness exercises, and more serious strength training to bulletproof my wrist. Around July, I started bouldering again, but the pain was still there. Bouldering was always the limiting factor for me; weirder holds (crimps outdoors don't give me issues, but slopers do) and higher intensity (when have you ever dyno'd on a 5.10?). Kinda just gave up bouldering for the most part, going maybe once every 1.5 weeks and keeping it fun and not too serious. I didn't mind, I prefer outdoor route climbing. - By the time September came along, I ramped up general strengthening and started trad climbing more. Crack climbing never gave me an issue, I was happy about that, and will probably focus on progressing on that instead of other types of climbing. Unfortunately, resistance training at home to get in better shape would often trigger my wrist pain. I'm talking basic exercises such as front raises, side raises, dumbbell clean and press (heavier loads). However, I started noticing that the pain was not the same as pre-op. Before, my pain would be triggered on the exterior side of my wrist when pushing through it or turning it (think push-ups or opening a jar). Now, the pain was being triggered when releasing hard pinches or actively powering through my entire forearm, and would shoot up my forearm from the exterior side of my wrist up to the elbow, almost following the scar of the surgery. - November rolls around, 1 year post-op meeting with the surgeon. I raise the issue, but from his side, and on the x-rays, everything looks as good as intended. The surgery did what the surgery set out to do; decreased positive ulnar deviance by a few mm's, and the non-union had fully healed. Impossible to come to a consensus on whether it was due to Exogen or active work (if you ask me, I was highly skeptical of Exogen, it felt like a massive scam and the research is biased and low-quality, but I might never had healed without it, we'll never know). Either ways, he basically says "from my perspective, nothing looks off". I'm still in pain, although a different pain than before. Woops. My current theory is that I ramped up bouldering a bit too soon, and gave myself some sort of chronic tendinopathy/something related to the scar tissue from the surgery that never had time to fully heal or follow along with my progress. - December 2020 rolls around, bouldering 2x a week or so, trying to go light 1/2 the time. Pain is seemingly inconsistent. Some days I can pull hard, some days I can't do anything because as soon as I release any grip I get a 8/10 shooting pain that has me groaning and massaging my arm afterwards. I see a climbing physio, he gives me some climbing-specific input but at the end of the day writes it off as some unknown tendinopathy; followed the usual exercises and stretches I'd been doing since the surgery to no avail. COVID ramps up, gyms close, time to ski. - Jump ahead to now, March 2020. Ramped way up my strength training, and my wrist is still a problem. I can trigger the pain artificially to test when its still there, and it hasnt left despite not bouldering or climbing in three months now. Maybe strength training is enough to not let it heal. I'm so sick of it, so I'm trying to schedule an MRI and follow up with a sports doctor to really see what the hell is going on in there. I'm positive I will still be able to do most of my climbing outdoors, as my wrist pain generally hasn't been a limiting factor, but I doubt I can go back to bouldering seriously anytime soon. TL;DR Had an unlucky non-union complication, osteotomy wouldn't heal. Few months of Exogen and some pushing working kickstarted the healing, hard to tell which factor helped it. Can climb outdoors with little pain, but have a new, different pain (possibly related to the surgery, but more likely due to ramping up bouldering too quickly) shooting up my forearm. No amount of physio or rest gets rid of it, same shit different story. My story is anecdotal, and for non-climbers I would definitely say go for the surgery. I just put a lot of strain on it despite the complication and might have messed up my recovery process. For climbers, take your healing and recovery seriously, and be wary of the strain bouldering can put on your forearm and wrist. Will try to update after getting my MRI to see what the forearm pain is about, but I don't think it's directly related to the surgery, I'm just SOL. |
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Hey Cheryl, please be patient! 2 weeks is nothing. As far as I remember, I was not able/not allowed to use my arm for at least 3 weeks and after that only carefully. I was allowed to go swimming as the first sport with arm use after 6 or was it 8 weeks? I started climbing after 3 months! The surgery is now 2 years ago and everything went fine. Still having a bit pain in arm or wrist during pull ups, but most times the right hand (with surgery) is much better than the left one (no surgery yet). I just had a second surgery a week ago (removement of the titanium) and it is really painful. I am able to use my hand now a bit, but still having pain and the doctor told me not to climb or do any kind of other sport for at least 3 weeks. I am also not allowed to go to work (software engineer) for 2 weeks. So, I don't know who told you that you can use your arm after 2 weeks after a ulna shortening, but I think you should be patient for a couple of weeks. Do some cooling, rest your arm on a pillow higher than your heart etc Get well soon Jasmin |
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Hey Lucas, the pain you described sounds familiar to me. It was very worse at the beginning, but got better and better over the time. And, yes, it is exactly at the moment when I release the grip. 2 years after it's still there, but I can live with it. It's just like a annoying background noice. I hope the new surgery isn't increasing it again. But like the last time I will start really slowly (UIAA 5 in toprope, actual limit is 8+ Redpoint). Perhaps you really started to hard? Don't know. I wish you all the best! |
Jasmin Roeper wrote: Hey Jasmin, That's quite reassuring to hear, I feel less alone in this! Any clues as to what it is, and anything you suggest to help it go away? |
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Hey Lucas, so my physiotherapist told me that it is the muscle. That it is too weak. But that is 1,5 years ago. I told my doc about this pain (he is a climber himself and has a lot famous climbers as clients) but as it is not really painful for me (luckily) we didn't follow up on this. Perhaps some kineseo tapes will help? Sorry, that's all I can say |
Heidi Kreiman wrote: Hi Heidi, Hows the healing going? I'm 5 months post op and delayed union. Lots of swelling in hand lately, increased pain. They aren't sure whats wrong. And for some reason below my elbow is a fare up area now. |
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https://regenexx.com/blog/ulnar-shortening/ |
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Ulnar shortening is thankfully being exposed in the medical research as a dumb idea. This is consistent with the many patients I’ve seen through the years who have had this surgery and regretted making that decision. So stay away from surgeons who want to rearrange your anatomy—it’s probably just fine how it is! |
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Regenexx may be a solution to some, but from my own research it seems very much like a scam. I dealt with a surgeon who’d operated on my knee for an emergency procedure and he was very objective about the pros and cons of the shortening - as well as the alternatives. FWIW I went through the public system and he had no personal incentive, fiscal or otherwise, to operate on me. Regenexx pays for all their own research and use self-referencing tactics as a facade for proper science-based medicine to sell their products. I’m sure Regenexx does very little harm, but I’m almost certain it does just as much healing. To each their own. For what it’s worth it’s now been over two years since my surgery and my wrist pain no longer hinders my daily life. I’ve gone from doing no pull-ups to being able to do 15 body weight, my route grade has jumped from 5.9 to 5.12, my bouldering from V4 to V6. I still have some residual pain in my wrist but in the long-term I have come out of the surgery thinking it was very much a success, despite the non-union complication that increased my healing time. |
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Hi Willow, it has been a few years since your post. Did you have any experience with the Stem Cell therapy or could you update on what route you took for your daughter and how she is doing? My 17 year old son is dealing with the same issue. Very gifted athlete and was looking forward to college sports. He is not able to perform to his ability due to the pain and lack of mobility. We are in the stage where we cannot do much as his growth plate shows he is not done growing. MRIs show no prior injury or tears. We are in the process of getting a 3rd opinion. My prayer is God will even his bones out for complete healing. |
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Why have you allowed Ken Richter’s statement about Ulnar shortening Surgery to be unnecessary and discredited to stay on here? All of the people dealing with such pain and difficulties do not need to hear that they made a wrong choice. They are here to find out other people’s experiences so they can tell if what they are experiencing is normal for this kind of surgery. |
