Two questions about my bones
September 11, 2015 1:07 PM Subscribe
In the past three years I have had two fairly major bone breaks. Neither has healed (bone parts have not fused back together). Is it likely I have some condition which prevents this? What symptoms should I look for? Does this question need to be resolved before I have surgery to plate this last bone back together?
Three years ago I split my patella vertically - a nice clean break. Theoretically, it should have knit itself back together, but it never did. It remains in two parts to this day. Then 4 months ago I fell and broke my wrist. After months of continued pain and limited mobility, a CT scan shows that part of my radius broke off and never re-attached. My doctor wants to do surgery - use a plate and screws to hold the end of the radius back together.
1. Before I do this surgery, should I look into the fact that twice my bones have broken and not healed? If I do have some type of disorder, should I get treated BEFORE we drill a bunch of holes in my radius for screws?
2. What kind of condition would cause this, and what would be the other obvious symptoms to look for?
Male, 50, overweight, pre-diabetic (impaired fasting glucose, have not reached diabetes numbers yet).
Three years ago I split my patella vertically - a nice clean break. Theoretically, it should have knit itself back together, but it never did. It remains in two parts to this day. Then 4 months ago I fell and broke my wrist. After months of continued pain and limited mobility, a CT scan shows that part of my radius broke off and never re-attached. My doctor wants to do surgery - use a plate and screws to hold the end of the radius back together.
1. Before I do this surgery, should I look into the fact that twice my bones have broken and not healed? If I do have some type of disorder, should I get treated BEFORE we drill a bunch of holes in my radius for screws?
2. What kind of condition would cause this, and what would be the other obvious symptoms to look for?
Male, 50, overweight, pre-diabetic (impaired fasting glucose, have not reached diabetes numbers yet).
Did you pose this question to your doctor? They'd be the right person to consult about bone defects.
posted by Hermione Granger at 1:15 PM on September 11, 2015
posted by Hermione Granger at 1:15 PM on September 11, 2015
Were these breaks evaluated immediately to see whether they'd need surgery? By an orthopedist and not just an ER x-ray? Lots of types of breaks don't knit back well without surgery. A relative of mine just broke her wrist and despite her advanced age and other major health problems, she was sent for surgery within days to insure a good heal. Both of your breaks sound like they were displaced/unstable fractures - those generally need surgery.
posted by quince at 1:27 PM on September 11, 2015
posted by quince at 1:27 PM on September 11, 2015
I agree that it's odd that they didn't do surgery to insert screws and a plate for a wrist fracture where the bone was displaced (I went through this about a year ago and they strongly recommended surgery - it's pretty common). I'd ask your doctor about this, and if they won't give you a straight answer (especially if they're the one that didn't recommend surgery in the first place) I'd try and get a second opinion.
posted by une_heure_pleine at 1:47 PM on September 11, 2015
posted by une_heure_pleine at 1:47 PM on September 11, 2015
Response by poster: I was hoping for some feedback on the two specific questions I asked (bone disorder)... anybody?
posted by Cardinal Fang! at 2:14 PM on September 11, 2015
posted by Cardinal Fang! at 2:14 PM on September 11, 2015
To be clear, I think that your bone breaks may have been medically mismanaged rather than you having a bone disease. You were likely a candidate for surgery for both based on your description. Go get a second opinion from an orthopedist. I'm not a/your doctor, etc.
posted by quince at 2:29 PM on September 11, 2015 [2 favorites]
posted by quince at 2:29 PM on September 11, 2015 [2 favorites]
1. It's really hard to say. You've had two fractures in three years which is really not all that bad. Plus, it's possible that both of your fractures are types of fractures that don't typically heal without surgical intervention- we can't possibly say because we are not your physician. In my layman's opinion, 2 breaks in 3 years of the type that can half the time lead to surgical intervention, it's not a huge deal that you're going in for a plate & screws.
2. There are SO many different types of rare diseases that cause bone breaks. You COULD google and drive yourself crazy, or you could bring your concerns to your surgeon/doctors. They really are THE people to be talking to about your body and your concerns.
posted by PorcineWithMe at 2:30 PM on September 11, 2015 [3 favorites]
2. There are SO many different types of rare diseases that cause bone breaks. You COULD google and drive yourself crazy, or you could bring your concerns to your surgeon/doctors. They really are THE people to be talking to about your body and your concerns.
posted by PorcineWithMe at 2:30 PM on September 11, 2015 [3 favorites]
Response by poster: Yeah, I guess I should have lead with the "of course I have seen doctors and of course I will see more doctors" statement. What I was looking for here is "are you aware of disorders that prevent broken bones from healing, and if so, are there other common symptoms I could look for" and "are you aware of bone disorders that I would want to address BEFORE my surgery".
Note that I got my diagnosis two days ago, and surgery is scheduled for two weeks from now. I have only talked to the current orthopedist whom I also believe mismanaged my fracture, and who completely blew off my "what about the fact that I've had two major bones that won't heal" question.
I can't find another orthopedist who will give me a second opinion in less than 4 weeks, and it is also not clear to me if there is another type of doc I should be asking the "bone disorder" question. So I either need to bite the bullet and delay the surgery (original ortho says "we should really get to this soon", which makes me wonder how bad delaying is at this point), or get used to the idea that I may get the surgery before I know if I should have gotten the bone test done first.
That is why the question appears here. So be assured that I have and will see docs, and that I know Ask MeFi is not a final diagnostic tool; but I am interested in feedback if people know about disorders that prevent bone healing, and if people have informed opinions about "there are disorders which would need to be treated before surgeries."
posted by Cardinal Fang! at 3:49 PM on September 11, 2015
Note that I got my diagnosis two days ago, and surgery is scheduled for two weeks from now. I have only talked to the current orthopedist whom I also believe mismanaged my fracture, and who completely blew off my "what about the fact that I've had two major bones that won't heal" question.
I can't find another orthopedist who will give me a second opinion in less than 4 weeks, and it is also not clear to me if there is another type of doc I should be asking the "bone disorder" question. So I either need to bite the bullet and delay the surgery (original ortho says "we should really get to this soon", which makes me wonder how bad delaying is at this point), or get used to the idea that I may get the surgery before I know if I should have gotten the bone test done first.
That is why the question appears here. So be assured that I have and will see docs, and that I know Ask MeFi is not a final diagnostic tool; but I am interested in feedback if people know about disorders that prevent bone healing, and if people have informed opinions about "there are disorders which would need to be treated before surgeries."
posted by Cardinal Fang! at 3:49 PM on September 11, 2015
Perhaps you would find this article insightful?
posted by reren at 4:16 PM on September 11, 2015 [2 favorites]
posted by reren at 4:16 PM on September 11, 2015 [2 favorites]
If you believe your current orthopedist who is scheduled to perform surgery on you mismanaged your original fracture, I would strongly suggest that you find a new orthopedist to perform the surgery (or assess if you need it), even if it means delaying the surgery. I'm honestly kind of confused as to why you would want to stay with a surgeon whom you believe already gave you subpar care.
You can find a list of common reasons that fractures may fail to heal here. There are rare disorders that cause pretty much everything under the sun, but as far as I know (I'm not your or anyone else's doctor), there are no common disorders that would call for non-surgical treatment for non-union of a fracture.
Again, however, if you do not trust your surgeon to make this assessment prior to your surgery, do not let this person operate on you. You don't have to cancel the surgery and sever your relationship with this person permanently -- you can delay the surgery by speaking to the surgeon's scheduling staff while you seek a second opinion or even schedule an additional pre-op appointment with your surgeon.
posted by telegraph at 4:23 PM on September 11, 2015 [6 favorites]
You can find a list of common reasons that fractures may fail to heal here. There are rare disorders that cause pretty much everything under the sun, but as far as I know (I'm not your or anyone else's doctor), there are no common disorders that would call for non-surgical treatment for non-union of a fracture.
Again, however, if you do not trust your surgeon to make this assessment prior to your surgery, do not let this person operate on you. You don't have to cancel the surgery and sever your relationship with this person permanently -- you can delay the surgery by speaking to the surgeon's scheduling staff while you seek a second opinion or even schedule an additional pre-op appointment with your surgeon.
posted by telegraph at 4:23 PM on September 11, 2015 [6 favorites]
Have you had a bone density test? Two breaks in 3 years seems high to me unless you're doing something very high risk (skate boarding, bike tricks, etc.) You're on par with my mom who has osteoporosis. Caltrate with vitamin D has made a big difference slowing down the time between fractures for her. I think giving extra calcium/magnesium/vit. D to help the bone rebuild really helps. You might try it to see if it makes a difference for you.
posted by stray thoughts at 4:34 PM on September 11, 2015
posted by stray thoughts at 4:34 PM on September 11, 2015
Type I diabetes is notorious for making bones more fragile and impairing the healing of fractures, and more recently very similar things are being said about type II:
A few years ago there was some excitement about the possibility that metformin (a standard treatment for type II) could counteract bone loss from a range of conditions, though lately that's been contradicted, but as far as I can tell, that hasn't ruled out the possibility that it could improve fracture healing by helping get diabetes under control.
posted by jamjam at 5:52 PM on September 11, 2015
Type 2 diabetes is associated with increased fracture risk and delayed facture healing; the underlying mechanism however remains poorly understood. ...And in light of that, I'd say it might be a good idea to initiate some kind of direct treatment for your pre-diabetic condition and wait for it to have an effect before having surgery to repair your wrist.
A few years ago there was some excitement about the possibility that metformin (a standard treatment for type II) could counteract bone loss from a range of conditions, though lately that's been contradicted, but as far as I can tell, that hasn't ruled out the possibility that it could improve fracture healing by helping get diabetes under control.
posted by jamjam at 5:52 PM on September 11, 2015
Response by poster: Marking as resolved. I was specifically looking for information on what would cause bones to fail to heal, not on what would cause bones to be easily broken. However, during surgery they determined that the bone actually had healed, just in the wrong place. So, the issue may be moot - I may not have a problem with bones healing.
Still, even with prompting and very specific follow up questions, I was surprised at how hard it was to get feedback on the actual question being asked...
posted by Cardinal Fang! at 1:57 PM on December 22, 2015
Still, even with prompting and very specific follow up questions, I was surprised at how hard it was to get feedback on the actual question being asked...
posted by Cardinal Fang! at 1:57 PM on December 22, 2015
This thread is closed to new comments.
posted by Cardinal Fang! at 1:12 PM on September 11, 2015