(Full break) spiral humorous fracture; surgery or let bone heal?

[MotherofDragonsUSA]

After a morning of being at the hospital helping my mom who has several medical Issues I was rushing to my own pulmonary rehab for persistent respiratory damage following my first Sept. covid infection then BOOM! Slipped on ICE in a parking lot, fully broke arm bone between elbow & shoulder.

Surgeon says let’s try for 3 weeks and see if bones can line up enough to stay the healing course, if then looks like right direction, then can stay the course but bones won’t even start repairing together until after 6 weeks. So I’m this brace a long time …

IMO Pain past 7 days has been beyond childbirth of multiples. Yep. And can’t sleep in a bed, have to use a chair. Trying to stay mentally strong to wait out and keep going from there, but ooh sounds like a long road from here in this state (arm & neck brace, unable to lay down, must ‘sleep’ in chair, a million schedules to coordinate and favors to ask to help with elementary kids who need me, be their day to day loving Mama, be positive & strong 💪)

Asked CLL specialist which is better prognosis for cll bone marrow cancer patients, will this actually heal on it own?

(when every other single cut or scrape takes forever for me!!)

OR

do I have better chance of recovery with metal plates or screws; how about bone grafting; marrow donation?

Seems like this spiral fracture and treatment options could go in many ways …

… CLL Specialist says we have have ‘no data’ about it. About cll-ER’s with broken bones surgery or healing, etc., that’s a bummer, was hoping to allow data to drive best course.

Anyone have experience with ‘spiral’ fractures with a full break? and how to best heal? Thoughts?

Thank you for your time 💕

[CycleWonder]

You are asking a reasonable question. I have one piece of data for you but it’s a bit of a stretch.

Shortly after being diagnosed with CLL when my lymphocyte count was maybe 15 at most, I was being treated for hip pain by orthopedists. I wanted my hip replaced and he was concerned about it being approved by the health insurance. I told him of my CLL diagnosis and he said, oh, that will do it. I think the theory was that if I needed a hip replacement, it was better to do it earlier than later on my CLL journey. But what the underlying concern is, I don’t know.

Not much help.

[MotherofDragonsUSA in reply to CycleWonder]

CycleWonder,

Thank you so much for your share. I feel it IS helpful. 😃

[SofiaDeo Administrator]

Oh No, so awful! Sorry to hear about this.

Eating more calcium rich foods will help with healing. Yoghurt, salmon with skin/bones (canned that you mash with sour cream or other dressing is easy once the can is open, put it on a salad or as a sandwich like chicken salad). You have kids, correct? Get them to open the cans, if you have a little food processor thing to put it & whatever mixer (sour cream, dressing) the salmon gets to a uniform consistency like a deviled ham, you can't tell the bones are there. I like sour cream or a salad dressing that doesn't contain eggs instead of mayo. If it takes a while to eat it, or I save half for another time, no salmonella concerns like with mayonnaise. Eat at least one of these daily if possible.

I hope you can arrange some help. Now is unfortunately not the time to be trying to do anything near your normal schedule. Please try not to use the arm as much as possible during this early stage. If the bones can realign properly, no surgery. Constant pressures from trying to "do things" with your other arm will put stressors on it as you mover your torso around. Stretching & flexing fingers should be OK, as is squeezing a ball or sock or something. The idea is to move the muscles only in a manner that isn't putting huge torsional pressure on the break. Just because you have a cast doesn't mean it's OK to use that arm constantly even if it didn't hurt.

Get more pain medication, call someone & complain. The US is underdosing a lot of people in response to the opioid problems here. You should be medicated enough to be merely uncomfortable during the day, but able to fall asleep.

[MotherofDragonsUSA in reply to SofiaDeo]

Thank you SofiaDeo. I don’t know if I can do salmon (it’s a great idea though!) but AM gonna get lots of yogurt in! Thank you again for the calcium rich reminder. 😊

And you are right. I have been using other arm to unload dishwasher, put away groceries, make kids sandwiches, text friends to help w carpool, even w my dad who came to help take the kids out a bunch I’m still doing so many things.

Thankfully when husband and dad brought up concern about using the pain meds doc told them to step off, that if anyone is to use that it’s me now. 😝

And a couple of weeks of it so I can try to rest at night (as I sit in a chair bc can’t lay down) will be ok, doc said.

[SofiaDeo Administrator in reply to MotherofDragonsUSA]

Seriously, please REST. This is a Spiral, not a regular ol' simple fracture. Stop jumping up & down doing stuff immediately. No wonder you have so much pain, your bone is trying to heal & you keep interfering with the process with all the movement. That's the root cause of the continued severe pain.

"Rest is the cornerstone of conservative treatment for spiral fractures. It is a vital component of the healing equation, allowing the body’s natural regenerative processes to take center stage. When a spiral fracture occurs, the bone needs time and stillness to mend itself. Immobilization, facilitated by casts, splints, or braces, plays a crucial role in this aspect."

brandonorthopedics.com/trea...

[MotherofDragonsUSA in reply to MotherofDragonsUSA]

Thank you so much SofiaDeo. Needed to read this. And will show those around me trying to help.

Healing & resting in the living room is not ideal but only place to put a recliner chair arriving today I am getting to ‘sleep’ on. My legs and feet have swelled adding to the discomfort. PCP says compression socks & elevation are all I can do for that (she says no diuretic bc they cause kidney problems?) This too shall pass. Trying to put my metal strength cap on. And from this moment will rest. Thank again for your kind support.

[SofiaDeo Administrator in reply to MotherofDragonsUSA]

As you recline or lie on your back, you can point & flex feet (one at a time lr both, to change it up/be less boring, rotate them at the ankle, a few minutes per hour. You can do a straight leg lift a few inches, to the top of the foot. I did these in alternating leg sets of 15-20 to strengthen & stabilize knee muscles. Tighten core muscles when doing this, make sure you aren't twisting your torso, it should stay still & just the leg move. You can also do some seated left lifts allowing the knee to bend. Deep breathing exercises are also likely OK. One can get blood moving around without twisting your torso much.

I am assuming you have an incentive spirometer if you have been having respiratory issues. Make sure your progress on that doesn't regress.

IDK your history so can't comment on if a diuretic is OK for you. If having someone pull on compression socks is difficult to do without you twisting your torso, maybe just see if the exercises help. It's unusual to have your legs & feet swell up from just a day or so of inactivity, IDK what else is going on that caused or contributed to that.

[MotherofDragonsUSA in reply to SofiaDeo]

Wee hours of the morning, can’t sleep, in living room, new recliner ehh, ouch, ugh m, can’t get comfortable bc of arm back pains, trying, doing exercises now, a silver lining,! THANK U SofiaDeo. Never had swelling before, see surgeon for x ray in 2 days so will show him for sure.

[SofiaDeo Administrator in reply to MotherofDragonsUSA]

Yes, it may be something minor. I once fell asleep in the sun Day 1 of a Florida vacation. My legs swelled up like balloons, and stayed that way for several weeks, through that vacation and back home. It took just a few doses of a diuretic to make that fluid move. You fell, some capillaries may have gotten bruised/compressed, you aren't moving a lot now so removing the fluid buildup is slow.

A spiral fracture has a much larger surface area that needs to knit back, compared to a simple fracture. So it can be more painful, as well as more difficult for everything to be aligned up perfectly as it heals. That's why the "no movement" is super important for a spiral.

I'll mention I broke my collarbone freshman year in college, and didn't rest as I was told to. I had problems with hairline fracture for over a year, it never really set properly as I was out, walking to class, etc. For years that break ached with major barometric pressure changes. I finally "healed" the visible lump with years of weight training, the bone smoothed out back to near normal over the years.

When I broke my toe, I did everything right, and ate calcium like crazy. Perfect healing, zero weather change problems.

So when I broke my leg near the ankle, I did everything they told me, and once again pushed the calcium. No twinges, I was skiing and hiking the next year.

Doing exactly what they tell you to do early on pays off in the long run.

[MotherofDragonsUSA]

Thanks Jammin_Me. Interesting question indeed … w&w so far .. hoping it stays that way .. not ready for treatment w my youngins

[Mprm]

I feel for you. Three weeks ago I slipped on ice and broke the radius bone in my right wrist and had many of the same questions you have asked—though my break is not as displaced as yours. I was given the option of plates and screws and chose to wait and see how the healing progressed. My thinking was that, with CLL, surgery would offer a new opportunity for problems, like infection and extended recovery time. (Also, I am on Ibrutinib, and would have to discontinue prior to any surgery.) It sounds like your doctor chose a conservative approach, saying wait and see if the bones realign, then decide whether to have surgery. I think there are a number of people in this forum who have successfully healed from knee and hip replacements, so bone healing shouldn’t be an issue with CLL—maybe someone else could weigh in on that. I hope you take advantage of any help friends and family offer. Rest and a healthy diet are so important—it takes a lot of energy to heal a bone.

[MotherofDragonsUSA in reply to Mprm]

Mprm,

Thank you so much for taking the time to share. How are you feeling & healing 3 weeks in? Sending good vibes & appreciation.

[Mprm in reply to MotherofDragonsUSA]

Thanks for the good vibes--I return them supercharged to you! For me, at around 2 1/2 weeks the pain and nausea diminished, though I still have some pain. I was told, as you were, that the body doesn't start to make new bone until around 6 weeks. It's a long wait, but it will pass!

[MotherofDragonsUSA in reply to Mprm]

Appreciate your shares, Thank you!

[Pearlpink]

Hi x my mother had same fracture a few years ago! Ouch! Until she had the fracture I had no idea that this type of fracture is not normally pinned. If I remember rightly, there was no added benefit from going to pinning first, so it sounds like you are doing the right thing. So it’s good that your consultant is observing you. Completely agree with Sofia! You have to rest and get advice from physio about stopping your shoulder getting stiff. I agree that you are basically the glue because it’s not pinned - so keep it still so it can heal. Xxx

It’s very important you don’t do things so that you don’t accidentally yank it etc so follow everything Sofia and everyone says x good luck x my mum healed wonderfully x

A recliner chair is great initially as it takes the pressure off the arm and helps the pain - but put the end up at night so it’s like a proper bed x

[MotherofDragonsUSA in reply to Pearlpink]

Thank you for sharing! The recliner is here! Unfortunately having difficulty in/it arm, brace sliding , pillow not right, trying to prop arm but trying! Can’t wait till Friday to see surgeon to get brace readjusted. It’s digging in, itchy, awful 😞 this too shall pass … a great reminder everyone please be careful of curbs and black ice, move w intention & body connection out & about in the community 😔 spiral break no bueno

[ViPOR]

So extremely sorry that you are going through this!! We Need our caregivers! My adult daughter was in a hurry to see me get my CAR T cells at NIH in Md and as she got out of her truck she tripped on the curb and broke her leg in two places! She then drove herself to,hospital and had surgery. She did not of course seeme..I was so upset when I heard this! I told her NEVER to be in a stressed rush state. Iit has np been hard for her.

[MotherofDragonsUSA in reply to ViPOR]

Oh my, I empathize completely, it’s a terrible feeling when others depend on you, and you are so distracted that you are rushing about. And my mom too, me having just ran from her health needs to try to support my own to then get home in time for kids to then get hurt … Aoy, she’s upset too. I hope you & your daughter both feel better soon. 💕 These experiences are great reminders everyone to please be careful & move w intention & body connection, don’t allow the mental stress to disrupt mind/body connection. I can’t go back, but must learn and make fundamental changes to create more support. Accidents happen, but do try to move connected. Hope all these shares helps others here on our forum prevent such injuries. 💕

[Deilginis]

I’m a lot older than you but was still pre-treatment when I got a very nasty compound fracture. Great surgeon did a super job with plates, screws, etc and I was back good as new! Did literally all I was advised to do. Wishing you the same outcome🌷

[MotherofDragonsUSA in reply to Deilginis]

Thank you for your share 💕

[Donnamccll]

I had a similar event earlier this year. I was diagnosed with COVID and a week later fell and broke my patella. I followed up with orthopedic surgeon, who tested my quad function and determined that I needed surgery. The surgery was relatively easy compared to the COVID aftermath recovery, which took 7+weeks. I would say that if surgery is suggested, do it. And advocate for yourself. I tell all of my doctors and nurses on each visit about my cll. They can take the necessary precautions. One thing I learned from this wonderful group is to advocate for yourself. And I am grateful to practice it.

[MotherofDragonsUSA in reply to Donnamccll]

advocate, yes! Thank u for the extra motivation, needed that to mentally push thru the pain today as I try to blast thru the insurance bureaucracy to get some aid support at least one a week. There are no showers in sight at this point with this very uncomfortable strapped up brace. ☹️

[Donnamccll in reply to MotherofDragonsUSA]

Embrace wipes! They have been my friend. And keep posting. It's a great outlet.

[Deilginis in reply to MotherofDragonsUSA]

Try Scrubz, disposable pre-soaped sponges, no rinsing required and leave you fresh as a daisy. They’re terrific!

[Big_Dee]

Hello MotherofDragonsUSA

I am not a doctor but sounds to me your doctor knows what he is doing. I had spiral wound complete breaks of tibia and fibula. This was long before I was diagnosed with CLL. After two days doctor decided to see if bones would heal without screws as skin had not been ruptured with risk of infection. After two weeks I could feel bones separating due to miss alignment which was not caught during initial hospital stay. Major orthopedic surgeon decided to rebreak and changed to fiberglass which was wound really, really tight. Took 8 months to heal but did not have to deal with pin/screw rejection. Not 100% but works fairly good. Hopes this helps. Blessings.

[MotherofDragonsUSA in reply to Big_Dee]

Thank you for sharing. Appreciate your share.,

[flutterbye]

Hi, I slipped on ice nearly 7 weeks ago, broke my ankle in 4 places. As my bones were not displaced I did not get surgery. Had to go to hospital every two weeks for a new cast and to treat my blister fractures 🙈 They would squeeze the cast into place around my ankle. Finally got a moon boot on yesterday but it’s really sore trying to put my weight on it. Still a lot of swelling which they said might not go away completely as it’s to do with lymphatic drainage. He did say if I got pins and plates in, it would have been worse as they would need to have cut through skin and tissue. I have been on Ibrutinib for just under nine and a half years. Good luck on your healing journey 🙏 Jacqueline

[MotherofDragonsUSA in reply to flutterbye]

Thank you Jacqueline for sharing. Hope you feel better soon in the boot! 🙏 Q: do you know, are we with cll able to drain & reduce swelling w massage therapy OR is that very bad idea? I’ll check for posts ..