96 Tears Part I

fabric tearing apart like a poorly healed fracture

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Art of the Arm by DJ Lynn

Update on the status of my arm injury.  After seeing the X rays during my doctor’s appointment of September 30, 2020 (three months post-op), I became concerned about things the doctor said and the report I read later. There were some words used including “disuse osteopenia”, “mild sclerosis” and “without evidence of significant interval healing at the visible media aspect”.  That last bit just meant the doctor couldn’t see much around all the metal, but disuse osteopenia and mild sclerosis?  That can’t be good.

I had another appointment on December 16, 2020 (about 6 months post op). This would basically be my last visit unless there were problems or unless I wanted to have a capsulotomy (surgical removal of scar tissue to increase range of motion). I could also have the metal plate covering the elbow removed since two screws were prominent and close to the surface at the tip of the elbow. As I read the X ray and doctor’s notes about the visit a couple of days later, I saw terms that concerned me including,  “generalized decreased bone mineralization” and “fracture lines are still visible in the AP view. It is hard to determine what percentage of bone healing.”

Because the doctor said she couldn’t see around the metal to determine healing, I called and asked to have a CT scan. I should note here that, as the doctor mentioned, when you have a lot of metal in your arm nothing can see around it or through it. Healing is determined by alignment of the hardware and whatever you can see of the bone, ligaments, surrounding tissue, and other things like pain. She agreed to the CT and I had it done a few days later and that’s when I became more concerned.

The CT report indicated that “fracture lines along the proximal ulna we’re still partially visualized” and “the distal aspect of a visualized non-united fragment of the proximal ulnar . . . with anterior displacement of its distal ends approximately 1 cm in relation to the remaining ulnar diaphysis. There is no evident fixation of this osseous fragment.”  In other words, according to this CT scan, there is a non-united, likely non-fixated fragment.

Now I’m worried that something wasn’t healing although my arm was feeling better, tighter, like it was healing. And I was able to move it more and use it more (gently) even though I had significantly less range of motion than a normal arm. But I’m a detail person so I went to see another doctor that had a great reputation specific to elbows to get a second opinion.

He showed me the CT on the screen and frankly I don’t see how anybody can make any heads or tails out of that! The CT made the metal in my arm so bright I thought it was impossible to see anything. Basically, he did not contradict anything the other doctor said and seemed completely unconcerned about the so called non-united fragment. His comment was, “I don’t see anything here that concerns me much. But I might have used a smaller radial head.”

Since my arm was feeling better and better and I was using it a little bit more although very gently – very little lifting, pushing or pulling (not more than a SmartWater bottle), I put it out of my thoughts. 

So, in February 2021, I contacted my original doctor and agreed to a second surgery to improve range of motion.

To be continued . . .

OMRON Complete™ Wireless Upper Arm Blood Pressure Monitor + EKG