My son broke his arm just above the wrist; both bones were broken. It was set with a pin. It healed with a 25 degree angle. The arm has a 25 degree angle just above the wrist and he can't put his hand flat and has limited rotation. What should I do?
As . As the other 2 physicians have noted, age is the most important factor. In a growing child, many deformities self-correct. The more growth left, the more it can correct. Most growth in the forearm occurs near the wrist, so we can accept more angulation there than elsewhere. As a child gets older, we can accept less and less deformity and we treat him/her more like an adult. If there is unacceptable deformity and loss of function, we would consider additional treatment. Sometimes we do have to wait for some "consolidation"--additional strength at the fracture site--before starting another treatment. Also, stiffness (loss of joint motion) is very rare in younger children, but can occur as they get older. Even a severe injury in a young child rarely needs therapy. In older children, some injuries will be severe enough to limit motion. If you don't feel the treating physician/surgeon is providing adequate answers, get a second opinion.
A . A lot will depend on the age of the patient. In a young patient it is not uncommon to have considerable angulation and often this will correct itself. Regardless, first thing is to call and follow up with your treating doctor and make sure he is aware of what's going on. Next speak with him about therapy and especially if this is an adult. If after therapy there is still a functional problem then, depending on how bad it is and assuming that this is not a very young patient, the doctor can consider re-breaking the bone. But this is a very last step and only if there is a definite functional issue and only if this is not a young patient where you need to wait till the bone "remodels".
Anguolation . Anguolation in the wrist may limit motion a little but have a greater affect on the midcarpal joint later. Angualtion in the forearm will more comomnly affect rotation. 25 degrees is a significant amount unless it is a very young child so i agree talk to the childs orthopedic surgeon. Often therapy will help but you need to ask if it be significant.