Doctors Lounge - Orthopedics Answers
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Forum Name: Bone trauma and fractures
|PluckyDuck - Mon Mar 30, 2009 1:16 am||
On December 20, 2008 I fractured my right 5th metacarpal after falling down stairs while carrying a box. It was a mid-shaft transverse fracture. Initially my orthopedist casted my hand, wrist, and fingers. However a follow up xray a week later revealed that the fracture had angulated even further, now more than 30 degrees. On January 2, 2009 the orthopedist percutaneously pinned the fracture. 5 weeks after surgery Xray showed no new bone growth, though everything was still properly aligned. After another two weeks the surgeon removed the pins, though had me continue to wear a rigid splint for another month. Last week I was finally allowed to return to work and stop wearing the splint. However, the doctor said that the xray still didn't show any new bone growth or callous. I'm wondering why this might be. Is it possible that there is new growth that just isn't showing up on Xray yet?
|Tom Plamondon PA-C - Sat Apr 04, 2009 9:18 pm||
It sounds like the 5th metacarpal fracture is showing non union. Risk factors for non union include infection, severe displacement or angulation, open fracture, comminuted fractures, poor blood supply, smokers, or poor stabilization of bony reduction.
You may need to internally fixate the bone again with small plate or nails or bone graft. But first you may use a bone scan with radionucleotide to see if there is good blood flow to the bone. This will help determine prognosis and if the bone should be fixed for a prolonged period of time.
Take care and let us know how it goes.
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