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Broken Humerus not healing, let nature take it's course?

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What is the worst that could happen if i stop going to my doctor due to a broken humerus 5 months ago due to an auto accident? Had surgery with screws and a plate. 3 screws have came loose and the plate is displaced. Was told i would need surgery again which will result in permanent wrist drop. My doctor acts like its my fault that this has happened although ive done everything he has advised me to do. What are the risks of just letting nature take its course and stopping treatment?
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First Helper User Profile Gaelic
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replied January 5th, 2012
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Tamcola,

It sounds like you have developed a nonunion of the humerus fracture. It also appears that you and your surgeon are not a compatible match.

You really need to find another orthopedic surgeon to take care of your arm. Because, it needs to be fixed.

If you leave it as it is currently, the changes of it healing on its own is almost zero. If the bone does not heal, then what usually happens is you develop a pseudoarthrosis through the fracture site and possibly a radial nerve palsy.


Surgery for a nonunion does not absolutely result in a radial nerve injury. It is one of the possible complications. Actually, the chances of an injury to the nerve occurring is higher is a pseudoarthrosis, than it is in surgery to fix a nonunion.


You need the function of your arm. The nonunion needs to be taken care of. This is not to say that you can't live without ever having it fixed. Many people have developed pseudoarthroses down through the years, but they all had significant disabilities. In modern times, it is usually recommended that the bone be fixed. But, that is totally up to you.


However, you should at least get a second opinion. Speak to another surgeon about your problem.

Good luck.
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replied March 13th, 2012
This was really good advice. An update. Found another orthopedic surgeon. Just came home from the hospital today following my second surgery, which went absolutely great!! There is no apparent nerve damage at all. A larger plate was put in with more screws. I also had a bone graft taken from my hip to help reconstruct the humerus. Am in quite a bit of pain at this moment but my prognosis is a full recovery of range of motion. I am very relieved and also very glad that I did not go back to my previous surgeon!!Thank you very much for the good information and advice!!!!!
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replied March 13th, 2012
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Tamcola,

Glad that you are doing well.

Patients often state that the hip graft site is more painful than the actual surgical site. Hope that you are not having too much problems with it.


Hopefully, with the bone stabilized and some graft in there to help just start the healing process the humerus will heal this time.


Don’t put too much of a bending moment (like trying to raise your arm with the elbow straight out) on the plate, till there is some callus formation (new bone). Do work on your finger and wrist motion. That will help with the swelling. Also, flex and extend the elbow (bring it up towards the mouth and let it straighten out completely). You can do the elbow motion by holding your upper arm against the chest wall with the other hand, if needed.

With the humerus fixed, you can do the pendulum exercises quickly. Start the pendulum exercises of the shoulder as soon as you feel comfortable doing so. You should be able to start some of the supported exercises of the shoulder fairly quickly, such as wall walks.

If you are going to go to physical therapy, they will show you all of these activities.


But, again, right now work on finger, wrist, and elbow motion. This will help to prevent swelling in the fingers and will help to pump blood/swelling back into the body core.



In getting the bone to heal, eat a good diet, with extra protein, calcium, vitamin D, and magnesium.

Also, if you smoke, you might want to quit till the bone is completely healed.



Good luck. Glad that you are doing well. Wishing you the best.
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Users who thank Gaelic for this post: Tamcola 

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replied March 13th, 2012
Especially eHealthy
Tamcola,

Glad that you are doing well.

Patients often state that the hip graft site is more painful than the actual surgical site. Hope that you are not having too much problems with it.


Hopefully, with the bone stabilized and some graft in there to help just start the healing process the humerus will heal this time.


Don’t put too much of a bending moment (like trying to raise your arm with the elbow straight out) on the plate, till there is some callus formation (new bone). Do work on your finger and wrist motion. That will help with the swelling. Also, flex and extend the elbow (bring it up towards the mouth and let it straighten out completely). You can do the elbow motion by holding your upper arm against the chest wall with the other hand, if needed.

With the humerus fixed, you can do the pendulum exercises quickly. Start the pendulum exercises of the shoulder as soon as you feel comfortable doing so. You should be able to start some of the supported exercises of the shoulder fairly quickly, such as wall walks.

If you are going to go to physical therapy, they will show you all of these activities.


But, again, right now work on finger, wrist, and elbow motion. This will help to prevent swelling in the fingers and will help to pump blood/swelling back into the body core.



In getting the bone to heal, eat a good diet, with extra protein, calcium, vitamin D, and magnesium.

Also, if you smoke, you might want to quit till the bone is completely healed.



Good luck. Glad that you are doing well. Wishing you the best.
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