What can I do about a 6 month old Non-union fracture?

[Blue5847]

Hello, for context a few months ago I got into a motorcycle accident and banged up my left thumb pretty bad. I went to a clinic and got x-rays done, which came back with a fracture that wasn't fully through the bone. Surgery was an option but because I don't have insurance, the doctor said we could also just align it with a cast, and that's what I did. I've had on and off pain from when I still had the cast on to now. After the time passed that I was supposed to wear the cast for, I foolishly removed the cast on my own. I researched about it and found out sometimes fractures take months to heal fully and can have some pain, but its been over 6 months now and my thumb is still in pain and nearly unusable. It has a decent range of motion but I can't put much pressure on it. I was hoping to get some advice or insight about what to do since I don't have insurance and the luxury of just walking into a doctors office. Any help will be much appreciated.

[Collywobbles64]

Hi Blue5847, sorry to hear you are in pain. As a UK resident it’s hard to offer any advice. It may just take time as often there is deep bruising. Alternatively you could try a splint yourself. Other things are taking vitamins and minerals for bone health ie magnesium, boron, vitamin k2 and vitamin d3.

[Met00]

I had a similar issue with a broken toe. Because it didn't appear to be healing, my GP referred me to a consultant, who sent me for further x-rays to see whether it was healing or not. A year down the line they thought it still hadn't fully healed, although weren't totally certain. At this point I paid to see a consultant privately because I felt I was simply being "fobbed off" by the NHS. He said he thought the bone had healed, but advised to increase my Vitamin D intake, the first time this had been mentioned. Apparently low Vit D can impede fracture healing, and mine had been low during the winter months, possibly for years! That was over 7 years ago and most of the time I forget about it now, but do occasionally still get minor pain. I went for physio a couple of years after the injury and that helped too.

You mention insurance, so I'm wondering whether you're in the US? If so, I can understand that this can be an issue. Our daughter lives there and when first married, she and her husband couldn't afford insurance so had to pay for any medical treatment. Even now, with good insurance cover, they still have to pay out a lot in co-pay! Living in the UK with "free" healthcare, it shocks me just how much Americans have to pay. Many people here have to pay for prescriptions, and for subsidised dental and eye appointments/treatment, but hospital treatment is free, as are GP and specialist consultations, xrays, scans and so on.

If your thumb hasn't healed properly, ideally you need to get it x-rayed to check what's going on. If you can't afford to see a health professional, I suggest you increase your Vitamin D intake (assuming you aren't already taking a high dose supplement) and if possible try to get some physiotherapy. Ideally you should get your Vitamin D blood level tested to check how much you need to supplement. I was told to get my blood level up to at least 75nmol/litre (if you're in the US, that's 30ng/ml), ideally 100nmol/litre (40ng/ml).

[wellness1]

I'm sorry to hear you're having issues so long after your fracture. It's truly terrible when the ability to pay determines access to treatment. You've received advice on supplements and hopefully you've optimised your nutrition. Two things that can interfere with bone healing are smoking and NSAIDs (things like Advil or Nurofen that many take for pain). Hopefully they told you that when you were treated.

Unfortunately, you might really want to consider seeing someone and getting a scan to find out what's actually going on. I'm sure you want to avoid ongoing pain, loss of function and complications that can arise from delayed healing.

I recently read about PEMF (Pulsed electromagnetic field therapy) for non-union, the term when a fracture doesn't heal properly. (there is some early research on these devices for osteoporosis) Sorry, I don't know how access to these bone stimulators works in the US, but I suspect it's through doctors.

"Some nonunions can be treated nonsurgically. The most common nonsurgical treatment is a bone stimulator. This small device delivers ultrasonic or pulsed electromagnetic waves that stimulate healing The patient places the stimulator on the skin over the nonunion from 20 minutes to several hours daily. This treatment must be used every day to be effective."

orthoinfo.aaos.org/en/disea...

Best of luck to you.

[Fruitandnutcase]

Hi Blue, I broke both bones in my wrist just over a year ago - in fact the cast came off a year ago on Thursday.

My wrist was ‘realigned’, it was obvious from the shape of it and the fact I couldn’t move any of my fingers that it was broken anyway but it was x-rayed, my nurse studied the x-rays then after two nurses stretched it between my elbow and my hand and a third nurse plastered it I was x-rayed again.

I was x-rayed again when they changed the plaster after a couple of days then (I think ) once more after that before the plaster came off but I was really surprised and slightly unhappy that I wasn’t x-rayed again when the plaster came off. Mainly because my hand was a mess and I could do absolutely nothing with it at that point. I could use my thumb which seemed to please the doctor who took the plaster off and the physiotherapists I worked with afterwards.

Bottom line is, even after a year my bones still ache for whatever reason. A friend who is a retired doctor told my husband right at the beginning it could take at least a year to recover from what had happened and it looks like he was spot on.

For a a long time like you I wondered about non union but I can use my wrist fairly normally to do the sort of things I want to do. It’s just that the bones still really ache and my wrist / hand still stiffens up especially in the morning and at night plus I ended up with CRPS which can happen to an unlucky few after my sort of accident and which has been a total nightmare.

Have you tried a Velcro splint or even a stretch support splint - a bit like a glove - for your wrist / thumb area - that would give you a bit of support.

We’re you given any exercises to do when you were in plaster? If so I would keep doing them - gently. If not have a look online - a lot of hospitals over here in the U.K. post their hand exercises on line. They are all very gentle but it’s the repetition that seems to count. Warm your thumb area before you do anything. Even do them in a bowl of warm water. I found it really good to fill a bowl with warm soapy water and basically guddle about squeezing out a wash cloth, I also found making crumble mix for on top of fruit pies very comforting and good physiotherapy and you would use your thumb for that.

Good luck, build up your vitamin D to help your bones and from my experience I’d say six months is no time at all, whatever you don’t do anything that actually causes pain. It’s one thing moving a stiff joint - but it shouldn’t cause pain.the best bit of advice I got was from a hand therapist who said I shouldn’t be working on a scale of more that 3/10 for effort. Up until then I was working on a scale of about 8/9 out of ten. Lowering my effort was the honestly best advice I was given.

[DeannaAlphi]

Hi there. Had a similar issue with my broken wrist, where I lost the normal use of my fingers. Had extensive hand therapy. Hand and wrist dipped in very warm melted wax which was lovely and took away the pain. Then lots of finger and wrist exercises. Bought myself a few toys to help, like squeezy things and coloured clay to play with while watching tv etc, Always soaked the wrist in hot water for ten mins before and after exercising. After a year of this, it was clear there could be no further improvement. Had surgery, they broke the wrist, realigned it and put a metal plate in to support it. Feels like a miracle. Only this week I was able to put on a pair of jeans, fasten the buttons and do up the zip. It isn't perfect, I still have to exercise my fingers and there is still some pain sometimes. It is good enough to play my ukelele to a fashion and I'm able to cook and peel vegetables etc. The wrist no longer looks deformed although the rather large scar does give the impression that I've cut my wrist. Was it worth it? Yes. We take so many things for granted until we lose them.

I'm no clinician, but I'd say if the bone is clearly mis alligned, no amount of supplements will fix it. I resisted surgery, determined to overcome things myself. I live in the UK so did not have to pay directly for the operation. If I did have to pay, I'd save my pennies until I could. In the meantime I send you my heartfelt empathy and encouragement to strengthen your thumb and other fingers as much as you are safely able to. xx