twitches post surgery?

[Ms_Demeanor]

In late February I fell while running and had 2 fractures at the base of the proximal phalanxes in the 4th and 5th fingers.  I had successful surgery and Kwires placed with the fingers in about 90 degrees flexion.  I am now able to have some movement of the fingers, but I find that my fingers twitch terribly as I do my therapy. My therapist says this happens sometimes, but she seems unable to explain why.  Could you explain the twitching that occurs with muscle use (flexion in particular)? Why is this happening? I know the muscles are in my arm and were not damaged, so why the twitchiness? Is it nerve conduction? or muscle weakness? And is there anything I can do to speed the twitches to leave me?  My pins are still in, and we expect they will be pulled this week. I am otherwise very healthy,36 yr old athletic, person take no medications beyond Motrin...no chronic disease. I just want to be able to tie my shoes again!!! (and drive my standard shift properly...)  Thank you all very much.

[Forum-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
     I suspect that the twitches that you describe are myoclonus, and are most likely related to prolonged lack of use of the muscles.  Muscles are electrical organ (they depend on ion gradients/electrical currents to signal the actin-myosin cross bridges to contract and with prolonged lack of use the become 'irritable' with a more erratic reaction to stimulation.  With physical therapy, I suspect these twitches will improve.  I would have your electrolytes checked (especially Na, K, Calcium, magnesium) since an imbalance can sometimes lead to myoclonus.  
I hope this has been helpful.

[BobbHilton]

Hi,
  In any movement disorder (abnormally moving limb or apart of it ) , the phenomenology is the crucial part before being able to localize the lesion anatomically. What you are describing could fit peripheral myoclonus (a hyperkinetic disorder due to a partial nerve damage) , in your case its the disribution of the ulnar nerve (The mechanism is assumed to be ephaptic transmission or in an easier english, naked nerves ,wires, talking to each other directly with no natural bariers) ....other less likely possibilties could be trauma induced dystonic posturing, or fasciculation.
    Though, you have a very big chance to improve spontaneously , but its better to arrange an appointment with a neurologist specialized in  peripheral nerve for a hand exam and a nerve conduction test first, and follow up the recovery plan with your hand surgeon


    Bob