What should be done about a non healed distal radial fracture? I broke my wrist in nov and had an external fixator. It was removed jan 4. Recent X-ray report says non healed distal radial fracture and avulsed ulnar styloid. What should my course of act
A . A lot of this is based on age. With increasing age, bones heal a bit slower. However, the distal radius is not an area where we usually see problems with healing. It's been about 3 months, which is a bit slow for this area. There are a few things that slow it down: smoking! (or any nicotine)--this is the single biggest factor in poor bone healing. If you use any form of nicotine, stop now! non-steroidal anti-inflammatory drugs (aspirin, advil, aleve, (naproxen) etc.)--these are second to nicotine in slowing bone healing. Avoid these as much as possible. If you take Aspirin for a heart condition, though, you should continue it. Motion--if the fracture does not have enough holding it in place, the healing tissue will be continually disrupted and you'll get soft healing, rather than bone. A cast or other means of immobilization can be helpful. Poor circulation--if there is a lot of soft tissue injury around the bone, the bone may not get a good blood supply to promote healing. There are electrical bone stimulators that help improve the "biology" of the area. Infection--with an external fixator (or any surgery), there is an increased chance of introducing bacteria to the area of the fracture. Antibiotics may suppress the infection until the bone heals or it may require additional surgery. In the longer term, if the bone fails to heal, internal stabilization and bone grafting may be a possibility, but this area usually heals.
If . If it is truly non healed and you have eliminated the issues in the other post then there are two options. Surgicsl treatment or non surgical treatment .
Locking Volar Plate. Locking Volar Plates were designed specifically for wrist fractures in the older patient with osteoporosis by Jorge Orbey MD about 20 years ago. The non-union rate is so low that his technique has spread around the world and has replaced external fixators 95% in my and other docs that do a lot of wrists. FIND A NEW DOC that uses a volar plates with 6 or 7 distal screws/pegs and get her opinion.