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I would be extremely grateful if you could spare the time to answer a couple of questions which would greatly assist my understanding.
On the 5th December 2003 I suffered a comminuted midshaft spiral fracture of the right humerus. After 22 weeks there was no sign of union and I had a bone graft and an IM Nail inserted. To date healing is disappointingly slow.
1. 7 weeks after the fracture occurred I noticed that due to a reduction in swelling my brace had slackened. Severe bruising had developed and when I removed the brace it was obvious that there was a deformity at the fracture site. Due to an ‘oversight’ at my local hospital it remained this way for a further 3 weeks when an xray confirmed that the fracture was displaced. Would this contribute to non-union?
2. For a period of 3 days after my operation no member of the nursing staff
reviewed my dressing even though my arm was extremely swollen and I was unable to move my fingers. The pain was excrutiating and it transpired that the blood had congealed on the bandage and was acting like a tourniquet. Would this contribute to delayed healing?
** I am 50 years old female and a smoker (no osteoporosis). I am aware that this can be a contributing factor.
In Reply to: humeral non/delayed union posted by mary [2751.295] on September 22, 2004 at 17:27:14:
First of all, it sounds like you had a very bad fracture to begin with.
How did your fracture get displaced? Were you wearing the brace as instructed- or did it really get that loose from the reduction in swelling?
A displaced fracture would contribute to non-union.
Post-operatively, the nurses should not be removing your dressing, that is the doctors responsibility. They should assess whether you have bleeding through the bandage, whether or not you can move your fingers, check your capillary refill (how quickly your nailbeds resume color when pressed), and radial pulses- if they could be felt through or around your dressing). Even though it was discovered that you had a tight bandage 3 days after your surgery, it is unlikely this impacted your healing long term.
Now, the fact that you are a smoker is definitely delaying your healing. I am sure you do not want to be lectured, but you should really consider quitting so you can resolve this problem.
Also- maybe supplements like oscal could help.
Has your orthopedist ever mentioned a bone stimulator? I am not sure if you could use it with an IM rod in place, but ask about it? It is electrical stimulation which helps bone growth ( a portable machine can be rented for home use).
Good luck in your healing.
Lauren
In Reply to: humeral non/delayed union posted by mary [2751.295] on September 22, 2004 at 17:27:14:
Hi, Mary.
It would be very hard to improve upon Lauren's note. Thanks, Lauren!
Walt
In Reply to: Re: humeral non/delayed union posted by Lauren [2247.14] on September 22, 2004 at 20:07:50:
Hi Lauren
Thank you for taking the time to respond. Much appreciated. It was a very nasty fracture and I followed all instructions to the letter. The brace was OK at time of fitting however within a week it felt really slack and the position of the plastic rivets wouldn't allow for tightening. When I offered to remove the brace in order to confirm my suspicions that something was wrong I was told that it was unneccessary. I was also informed that because of the nature of the fracture I had to expect extreme pain therefore why didn't I just try some paracetemol along with the co-proximol!!!!!!!!!!!
I am attending a physiotherapist plus hydrotherapy unit. They reckon I could have radial nerve damage which is slowing down my recovery. No one has ever used a bone stimulator on my arm. I will ask about it though.
Thanks again Lauren.
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