Q: My right arm was crushed completely snapping both radius and ulna at their mid-points. Surgery was done immediately and steel plates are supporting both bones now. It has been three weeks and I want to know when exercise involving weight training can be done. I am an otherwise healthy male, 28 years old and 170 pounds. And could you please answer these questions: 1. Do the plates need to be removed? 2. When can I exercise? 3. Can I use muscle creams? I just want to get a timeline for my recovery. What I should / should not be doing. My doctor has not given me much information.

A:Fractures of both the forearm bones are major injuries to the upper limb. The exercise protocol is fairly straight forward if the surgeon is confident that the fixation has been good the surgeon can leave the forearm without the plaster. The patient can do active range of movement exercises of wrist, elbow and shoulder. However, these must not be against resistance. You are allowed to do clenching and opening of the fist, moving the wrist down and up, bending and straightening the elbow, taking the arm overhead in all this one movement is absolutely contraindicated. This movement is rotating the forearm as in opening and closing a bottle (we call it pronation and supination). This is allowed only when the fracture shows evidence of union. This usually takes about six weeks. To answer your questions: 1. It is not always necessary to takes the plates out. However, ideally it is better to take them out. Usually this is done one and half year after fracture union. 2. As explained above. Exercises can start immediately. Load bearing after fracture union. Impact exercises as in boxing should not be before solid union of the fracture and remodeling has taken place. Reasonable load bearing is possible in six months but impacts only one to one and half years. 3. There is no need to use muscle creams.