Healing of a fractured bone is quite a complex process but I will try to simplify.
To understand the process better we need to have an idea about the anatomy of the bone. Bone is surrounded by a thin membranous layer of tissue called periosteum ( See adjoining Figure – The figure represents a cut section through a bone. Normally the bone is like a cyllinder. Imagine cyllinder cut into halves along its longitudinal axis and you would get a similar picture. ).
When bone breaks, it bleeds from its torn ends due to disruption of its supplying vessels. Quite naturally the periosteum also is torn as shown in the figure. This periosteum may be completely torn or partially damaged depending upon the force of injury. The collected blood is called fracture hematoma.
Due to loss of vascularity or blood supply adjacent portion of broken ends die. Inflammation changes occur in the haematoma over next few hours ( A reaction by the body which occurs whenever there is an insult to a part or structure. The basic purpose of the inflammation is to contain the damage and facilitate the healing and regeneration. Inflammation is responsible for redness, pain, warmth and tenderness of the wounds and abcesses) .
This inflammation brings in many cells that would help in regeneration of the broken bone. Periosteum plays a vital role in fracture healing. The periosteum is the primary source of precursor cells which develop into chondroblasts( cartilage cells) and osteoblasts ( bone cells) that are essential to the healing of bone. as the time progresses, the fibroblasts ( A kind of cells which produce fibrous tissue in the body) get interspersed with small vesels and form a loose mesh like structure uniting the broken ends of the bone and on which the future layers of bone tissue would be added. this structue is called granulation tissue.
Over the next few days, the cells of the periosteum replicate and transform. The periosteal cells proximal to the fracture gap develop into chondroblasts and form hyaline cartilage. The periosteal cells distal to the fracture gap develop into osteoblasts and form woven bone a kind of bone which is structurally different from the lamellar bone oound in the body.
These two new tissues grow in size until they unite with their counterparts from other pieces of the fracture. This process forms the fracture callus. the callus is the first sign of union visible in x-ray and generally appears around two weeks after fracture. Eventually, the fracture gap is bridged by the cartilage and woven bone, restoring some of its original strength. A picture like this is produced.
From here on slowly and steadily bone is restructured by a process called remodeling.
I also have swelling on the the foot since last 2 months. Do I have to do something for that?
Dr Arun Pal Singh Reply:
March 24th, 2010 at 11:51 pm
@kishore,
This should go. If it is large, then consult with your doctor.
hello doc i posted once before but it was removed i am not sure why, my problem is i broke my humureus mid shaft clean break no bones peircced through the skin, the doc put me in a u slab for 1 week and i have been in a humureus brace for 3 weeks, last x ray was at week 2 which showed good allignment doc was very happy and said i would be able take brace off in further 4 weeks, where my problem lies is that i do not have any control over my right arm, i can move my fingers, wrist and write feel everything along my forearm can rotate my shoulder but i can not move my arm up or down or let my arm rest without a sling as i feel a great sensation of pain near my bicep and elbow, could you please tell me if its normal and when will i gain sufficient control of my arm. thanks in advance
Dr Arun Pal Singh Reply:
March 24th, 2010 at 7:49 pm
@Imran,
A fracture takes around 6-8 weeks to heal. Following that you would need to work out with physiotherapy.
Probably another 15 days.
Good luck
Hi – I have a spiral fracture of the upper humerus. It has been 8 weeks since the injury. I was x-rayed after 7 weeks & the bone is aligned; however it is not showing signs of forming union. Does it need surgery to heal? I have been told that they will x-ray me again in 4 weeks as “there is no point in x-raying me sooner”. How long will it yake before they decide to try surgery.
Dr Arun Pal Singh Reply:
July 5th, 2010 at 12:37 pm
@Deb,
I think they would make decision next week. If bone has not attempted to unite till now, it is less likely.
Have a word with your treating doctor when you meet him next time.
hello, i got 5th metarsal rt foot fracture on march 27, 2010 and was casted on 6th april for 1 month. I consulted Dr. for healing, he said healing is ok. But still i m having swelling on rt. foot while walking / sitting. Pl. advise
Dr Arun Pal Singh Reply:
July 5th, 2010 at 12:44 pm
@sukhjinder singh,
Swelling is different from bone healing and can continue for a period even after union.
It would go with time.
Had a compression plate installed on my left humerus in Jan after a midshaft displaced fracture in Nov. Am thinking I might want it removed if I’m still aware/bothered by the sensation of the hardware next Jan or so.
1. Is the removal of the plate and its 6 screws much simpler/safer than the initial install?
2. Is the chance of a re-break any more or less likely after removal? Intuitively, I thought that the plate gives additional protection from that, but now I’m not so sure. Both ends of the plate seem to form a pair of fulcrums that could increase the chance of new breaks at those points.
I’m a fairly active 66 year old who engages in manual labor like mowing, weed-eating, fencepost driving and tractoring, so I’m subjecting the arm to some fairly jolting, jarring activity.
Dr Arun Pal Singh Reply:
July 16th, 2010 at 8:15 am
@Bill Stacy,
1. It is almost a surgery of same magnitude though the duration would be shorter.
2 Yes! You would need to be in plaster for 6 weeks after removal. The screws removed would leave holes which weakens the bone. Hence the protection.
I hope that helps.
broke upper humerous clean 3 weeks ago. Is on and off pain normal,? Is there stability in the boes already as currently there is no displacement and wonder how easy they could become displaced? I worry it could shift while sleeping or walking but this might seem crazy? Also, is swelling still to be expected in my forearm?
Thanks
Dr Arun Pal Singh Reply:
July 16th, 2010 at 8:32 am
@james bartsch,
Too many questions but little information to help me to deduce an answer.
What is your age?
What treatment has been given?
What is level of the fracture?
i Thought i should leave a little update if you scroll to the top you will see i broke my humerus mid shift clean break, my docs decided on self healing so i had a u slab with a compression brace.
I just wanted people to know it was a long recovery and still going on. initially i couldn’t move my arm for 7 weeks, i tried many times but my arm wouldn’t function little by little and i mean little i started moving my arm here after, baby steps weeks 8 -12 really week grip. 12 – 16 more free movement coming back but still find it difficult to lift stuff which weights a fear amount should be seeing my doc for final x rays to see how its mended. I personally think i have another 4 weeks before i can start some sort of proper exercise on it, but only on docs advice. i hope this helps anyone as i was worried reading horror stories about people not gaining any sort of arm movements or sensations for 6 months
37 yr old male, broke humerous just below shoulder, is not displaced, clean break. Have been in collar and cuff sling last 2 weeks, first 2 weeks u-slab sling. Just had xray, one day shy of 4 week mark, no calus showing yet. Should I be worried about non union and surgery or does it just take a few more weeks to show progress? Also do you have any nutrion tips to speed healing. I was a smoker but heard it hindered bone growth so quit 2 weeks ago, one positive from the fracture.
Thanks
Dr Arun Pal Singh Reply:
July 28th, 2010 at 4:48 pm
@James,
Give your fracture some more time.
Hi !!! I am wondering — how fast can a hairline fracture near the base of the fifth proxima phalanx takes to heal ?? I am asking under general condition with no stress added to it. Also do I need a big cast to wear??? I appled heat treatment on –at the very moment of the impact and Hirudroid cream that worked marvellously. The swelling and pain gone within 2 days and I sought a GP advise. He refer me to an Orthopaedic doctor for next Monday appointment and I am posting to you now during the weekend.
Dr Arun Pal Singh Reply:
August 2nd, 2010 at 3:11 pm
@Melanie,
On an average four weeks. An immobilsation is advised. It may not be in form of plaster but it is advised.
All the best.
Hi I broke my right fibula bone (lower leg) on June 20th 2010. It was a clean break with no surgery required. I was in a splint for 10 days and than a cast for 6 weeks. My cast was removed on Wed August 4th. The doctor said that my bone is not fully healed and i should only walk lightly (no jogging) on it for the next 3 weeks until my follow up appointment. It still hurts and I have a burning sensation at night. Is this common to let someone with a broken bone to walk on it with no cast? Is it possible to delay healing or cause more injury within these next 3 weeks? What if my bone is not healed in the next 3 weeks? Will they put another cast on?
Any reassurance will be much appreciated.
Thanks
Dr Arun Pal Singh Reply:
August 13th, 2010 at 3:50 pm
@Anna G,
If your bone has healed enough to take the cast out, I do not think you can injure it with your routine activity.
And if it is healing, it should further heal with time.
Let me know.
Hi Doctor,
I fractured my fifth metatarsal on my left foot. I’m in an aircast as of now, and I have a boot that i put on when I go to sleep. I’ve noticed that after two weeks, I have a weird, painful sensation where the fracture is. I can’t describe it, but it’s just a quick jolt when I move my foot in a weird position in the cast.
Is this normal during a fracture heal?
Dr Arun Pal Singh Reply:
August 13th, 2010 at 3:52 pm
@Robert Y,
A cast annot give you 1000% immobilization. Therefore it is advisable not to put your foot in weird position.
Whenever you move the fracture or attempt the movement, it would pain.
Take care.
fibula fx undiagnosed for 10 months. non-union with large gap, no bone. surg. done/debridement+bone plate, screws. developed non-healing wound which started first day surgical sutures removed with seepage near ankle area. many debridements of this open wound with pale, yellow drainage went on for next 8 months and 5 rounds of deifferent antibiotics for all this time(on bactrim x 35 days at present b.i.d.. Ha surgery #2bone plate removal and more fibula bone necrotic so removed more bone and cannot have a plate again. now diag. with osteomyelitis. lower leg gets purplish blue and turns snow white when push on skin with fingers. when up all day, ankleg, lower leg swells. developed lg abscess at fx site and had to be milked at top of old surgical incision which went down and pus type fl. came pouring out down at bottom where open wound hole was. fib. bone culture showed staphy. auerus and deep tissue culture showed staph. lugdunesis. now, it’s been 6 weeks since emoval of plate, screws and see hole at lower leg where chronic non-healing wound is trying to come back along with a 2nd sunk in area which looks like maybe a 2nd hole opening will eventually appear. Questons: what will be the negative affects of a large area of no fibula bone, lower third of leg cause as far( as running, jumping, twisting body around to look at something, stooping to the floor, using treadmill, long ex. walks, etc, and can you think of any other things wihich may change in my life besides these?).
Dr Arun Pal Singh Reply:
August 27th, 2010 at 9:14 am
@sandy c.,
I need to know the level of the fracture. A recent xray would be helpful.
What are the problems that you are facing in your daily routine life.
forgot to say had hip bone grat on first surgery which was mostly eaten up when they went in on 2nd surgery and this all was debrided with extra fib. bone removed to healthy bone. will the germs get into my bone left and can it develope into a sinus tract and get over into my tibia eventually?
I got my fibula fractured on the ankle 7 weeks back,still the cast is there.There is also a crack in tabula on the ankle. How much time it will take in bone healing and do I need physiotherapy after the cast is removed. when will I be able to walk normally without the walker.
Dr Arun Pal Singh Reply:
September 2nd, 2010 at 6:45 am
@Anu,
Fracture generally heals within 6-8 weeks in most cases. It is followed by pohysiothearpy which may take other 2-4 weeks.
All the best.
I have had a tibial stress fracture since April from overtraining. I have not been running since and am now in a boot and there is still no change. I am taking a calcium supplement with 500mg of calcium and 500iu vitamin D twice a day. Is there something more I can be doing to help speed recovery?
Dr Arun Pal Singh Reply:
September 2nd, 2010 at 6:45 am
@Melanie,
How long you have been on boot? A stress fracture should heal within 4-6 weeks.
Broke collar bone 5 weeks ago – bone slightly attached – had x-ray last week and no sign of any callus forming – x-ray was not much changed from original x-ray. Am I worrying too much?!!
Thanks
Dr Arun Pal Singh Reply:
September 2nd, 2010 at 7:34 am
@Graeme,
No! You are rightly concerned. Absence of callus after this period might suggest that bone is not uniting.
Speak to your doctor if another xray after 2 weeks shows the same
Dr. singh i broke my metacarpal bone from punching a solid object with a closed fist. from what i remember the dr said it was shattered and that i would need surgery . the fracture happen i believe on the 4th or 5th bone also sometime called boxers fracture. i wanted to know what if i didnt do surgery what is the possibility of it healing on its own if i keep a splint on?
Dr Arun Pal Singh Reply:
September 14th, 2010 at 6:47 am
@ahmad,
Metacarpal fractures usually unite on their own too but surgery is advised if the position is not satisfactory.
my maid who is 18 yrs old , got a bullet pierced in her left forearm. x-ray revealed the bullet to be stuck in ulnar bone.doctors put a splint and bandaged her forearm saying that the bullet cannot be removed as she is 4 months pregnant.
why cant the bullet be removed?
Dr Arun Pal Singh Reply:
September 14th, 2010 at 6:56 am
@yasha younes,
Bullet is a foreign body. But leaving it as such does not cause any problem due to its inertness.
Second trimester of pregnancy is relatively safer to get any surgery. But any surgery does subjects the foetus to extra risk during entire period of pregnancy.
Therefore most of doctors recommend and do only surgeries which are necessary.
The choice of surgery in your case is entirely dependent on the decision made by the patient after understanding the risks involved.
Hi Doc, My Tibia and fibula is broken due to road accident. Got operated by inserting Titanium rod below knee joint till ankel. It has been almost 4 week now. I just wanted to know how much time it will take to get completely ok. And the rod is only used to joint my tibia and not fibula. Does Fibula get joint or alligne automatatically.
Pls reply
Dr Arun Pal Singh Reply:
October 3rd, 2010 at 6:28 am
@Vasim,
Completely OK is avery relative term. In case of fractures we are concerned with union of bone which would take around 8-12 weeks.
This is followed by a period of rehabilitation which again is variable with different people. Usual duration is 4-12 weeks.
Most of the people are able to get back to their chores by this time.
Left forearm of my son, broke on 12 june 2010. He was operated at Rawalpindi Pakistan on 17 june 2010 and two plates were fixed . Now after three months of operation one bone is sufficiently healded while there is gap in eluna where some grafting was done . How long it will take for the gap to heal.
Dr Arun Pal Singh Reply:
October 3rd, 2010 at 6:41 am
@Muhammad Nadeem Khan,
Can I please see the xrays?
Hi Dr, I am 43 year old woman, with 3 hairline fractures on the ball of my right arm humerus. It occured on Sept 3,2010. I am using the sling as advised. The shoulder specialist advised me on Sept 17th to start rotating my arm slowly. Everyday, there is new pain in my upper right side. I do the in home physio as directed but am worried that i might injur the callus! Has the callus formed already? I don’t have any displaced segments. How long should it be until full recovery?
thanks
Dr Arun Pal Singh Reply:
October 3rd, 2010 at 6:44 am
@Lizy,
Your fractures would have healed by now. How are you?
My aunt has a gap somewhere in her spine. As a result, she has constant pain, can’t walk and has to be careful when she sits, walks, etc. She had an X-ray some while ago – that’s how she found out she has a gap in her spine. Now she’s so worried, she keeps on crying non-stop. What happened to her? Would her spine heal by itself or would she need to go through some kind of surgery? I’m just looking for some advice so that I can comfort her once I know that she’s not going through a horrify thing.
Dr Arun Pal Singh Reply:
October 3rd, 2010 at 7:08 am
@Haj,
Gap in the spine does not suggest any meaning. You would need to elaborate about her condition.
Rather, you should visit a specialist and seek an opinion.
Gap in the spine is a loose term that makes no sense at all even if it was used by a doctor to explain some process in vernacular language.
I broke my right distal radius. How long should I put ice on the cast to help with swelling? Do you ever use warm compresses to reduce the bruising? Thank you?
Dr Arun Pal Singh Reply:
October 15th, 2010 at 11:46 am
@Stephanie,
Did you visit a specialist?
In set of acute injury warm compresses are not recommended.
Hi, i have a distal phalanx fracture in my great toe. Was put into a half cast for one week and the ortho doc says i can walk without immobilization already? It has been 3 weeks since the accident and now i can walk without pain at all.
But my concern is when i bend my great toe to a certain extent, it kinda hurts. And when i press on my great toe, i can actually feel my distal phalanx ‘moving’ or ‘grinding’ against each other. Is that how a non union feels like?
Today marks the last day of 3 weeks. Tomorrow will be the starting of the 4th week. The ortho doc had scheduled another x ray appointment on the 6th week.
So should i be worried now and go for an early x ray appointment or should i wait for the 6th week mark? And is the pain when bending too much of the toe and the feeling of the fractured bone ‘grinding’ or ‘moving’ against each other normal?
Hope to get a reply real soon Mr doc, millions of thanks in advance.
Dr Arun Pal Singh Reply:
October 15th, 2010 at 11:55 am
@ricky,
A fracture usually takes 6-8 weeks to heal. I think you are doing fine.
Your fragments must have started to unite but their may not be enough strength in the union which would come gradually.
Its 10 days since you posted and I could not answer it before.
Sorry.
How are you now?
Dear dr Singh I have fractured my 5th matartarsal and it’s a hairline fracture no disposition or anything my foot is wrapped in a soft splin it isnt loose fairly snuggled with 2 layers I wonder is that good enough? I also have a cam cast boot but only wear it when I decide to step outside I am 6’6 290 what’s the best thing for me to do ? How long would you guess or believe it will heal?? It wud be nice if you could answer those question
Dr Arun Pal Singh Reply:
October 15th, 2010 at 12:02 pm
@Carma,
A hairline fracture should heal in about 4 weeks. You are being treated adequately.
Thanks for the response Dr. much appreciated. I am able to make bigger circles using my shoulder joint. There is still heaviness and stiffness in that area. I have another clinic appt on Friday the 15th. How long do you think it will take me to get my normal arm back? This is my dominant arm and I can’t do much with my left hand.
Dr Arun Pal Singh Reply:
October 15th, 2010 at 12:06 pm
@Lizy,
Welcome. It would take few weeks. Few could mean up t 6 weeks.
I crushed my right thumb at work which resulted in a complete open fracture of my distal phalanx, it is not affecting the joint, just the top half is broken in two. I had a splint on for 2 weeks with daily dressing changes. I went to the doctor to get my stitches removed and the xray was similar to xray the day of the accident, there is still a 2~mm gap between bone ends. Is it normal for there to be little repair in 2 weeks? whats the worst case scenario? thank you
Dr Arun Pal Singh Reply:
October 15th, 2010 at 3:50 pm
@Anthony,
2 weeks would not show any radiological changes.
Get an xray after two weeks.
Hi, thanks for your reply!
I am doing great now, no more feeling of the grinding or moving of the broken bones when i press on it or walk on it. But when i extend my leg straight and bend my big toe, i still can feel something in my great toe, is that normal?
3 more days and it will be the starting of week 6. And I cannot really bend my toe all the way back.
Hope to get a reply soon!
Dr Arun Pal Singh Reply:
October 29th, 2010 at 9:18 pm
@ricky,
I hope you are quite better now. I try a lot but somehow could not reply early.
Its bad habit but had been really busy with few things.
Sorry.
I broke my ankle where the lower end of the femur connects to it. No surgery all i was given was an aircast. It has been 3 weeks since the fracture and was wondering if the swelling that is still present is normal. I am able to walk now but my ankle is still kind of stiff without the aircast on. Thanks
Dr Arun Pal Singh Reply:
November 4th, 2010 at 6:55 am
@Cameron,
Something is wrongly stated. Femur bone does not come to ankle.
Is it Tibia you are talking about?
Hello Dr. Arun,
Two weeks ago I’ve fractured my right ring finger bone. See link for x-ray image.
The doctor gave me 2 option to cast it or a surgery installing a pins. I choose to cast it. If you can see the x-ray image above, the bones were not properly align. What should I do? Should I undergo surgery with pins or let it heal on a cast?
If I let it heal with a cast, what kind of problem should I occur?
Thanks,
Don
Dr Arun Pal Singh Reply:
November 11th, 2010 at 12:16 pm
@Don,
I do not why but your image did not load. How are things now?
Add:
Yes it did fianlly. Because the injury is near the joint, a fixation would have served you better.
Hi, i fractured my fibula, but it was stable and did not need surgery. i had a fiberglass cast put on Monday but it feels tight at the arch of my foot, i get a burning sensation and pain at random times. i went back to hospital on thursday about my concerns but they said it was not worth taking the cast off becase it would be too lose, they just said to keep my leg elevated above heart..i have been keeping it elevated but it still hurts and still getting the burning sensation, should i go back and get the cast changed? ? thanks
Dr Arun Pal Singh Reply:
November 11th, 2010 at 11:52 am
@mya,
My reply may be late for you but yess you need to change it if it feels too tight.
Dear sir, I need your advice in case on my mother, she is aged 71, she fallen down at home 5 weeks ago, since then she is undergoing treatment by orthopedic, giving her pain kiler medicine and protin, vitamin, calcium etd. and diognised as compression in vertevrea namely D-10 & D-12, she has constant lower back pain both side but more in right side, she has also stomach problem and toilet going is very irregular, stool does not pass up to 3 to 4 days, our doctor suggests kiphoplasty if there is no relief in pain, what should I do ? she has bed rest but pill is not working to relief from pain, also reducing the body, please guide me, is it possibe to cure by medicine and rest ? or any other non operative treatment is there ?
Dr Arun Pal Singh Reply:
November 11th, 2010 at 12:20 pm
@Rajesh,
Medicine and rest followed by physiotherapy are the mainstays of the treatment.
Role of kyphoplasty is debatable but some studies have reported good pain relief.
BTW how are things now?
Hi Dr.
I sprained my ankle from a fall ( I jumped off a high deck in the dark) & was examined with a nondisplaced oblique fracture on the most lateral aspect of the dome of the talus. The tibiotalar joint is intact, there is lateral soft tissue swelling. I am a 32 year very active male.
So I got an x-ray 7 weeks later as a follow up and the x-ray came up unchanged. These were seen by 2 separate radiologists. I got an a opinion from an orthopedic Dr. a few days ago who looked at the x-rays and said there is healing occuring although he feels there may be a trimalleolar fracture and maybe a ruptured tendon. He said he does not think that surgery is needed, if anything to clean things up but that he does not feel that’s necessary since things look okay and that I am doing what I need to be doing staying off of it.
He recommended getting a cam walker or air boot to put my foot in.
He also said that I would have pain for 6 – 12 months but did not give me a time frame for complete healing. Also, I was told not to weight bear (which I have not, I’ve been in a splint and on crutches for almost 8 weeks now) but that I should start moving the ankle around like doing the ABC’s to prevent fibrosis. I am going to another orthopedic Dr. in 2 weeks for another x-ray and get a second opinion.
I just want to get your opinion on how long healing may take until I am 100% & the fact that what I am reading about trimalleolar fractures (if that’s what I have) usually require surgery.
Thanks, I appreciate your feedback.
Tom
Dr Arun Pal Singh Reply:
November 10th, 2010 at 10:34 pm
@Tom,
It is difficult for me to commend on your situation as I d not have the complete info.
In fact what you say is bit confusing.
First you mention that it was talar dome fracture. I do not think that can be confused with trimalleolar fracture as both the fractures involve different bones.
Can I look at the xray?
Hi I posted a question about a month ago, and I have an update.
It has now been over 6 weeks since I received a tuft fracture of my distal phalanx on my right thumb.
The X-rays show basically no improvement since the day of accident, the bone ends are STILL completely separated. Is this normal? the X-rays from day 1, 2 weeks and 6 weeks look all the same.
Dr Arun Pal Singh Reply:
November 14th, 2010 at 7:47 am
@Anthony,
Can I have a lok at both the xrays. How are your symptoms?
Sorry it is the Fibula that I broke. It has been a month now. I am walking normally it is still sore though when i try to jog and turn real fast. Is that normal?
Dr Arun Pal Singh Reply:
November 14th, 2010 at 11:29 am
@Cameron,
It should get better with time.
All the best.
Dr Arun Pal Singh Reply:
November 11th, 2010 at 12:16 pm
@Don,
I do not why but your image did not load. How are things now?
Add:
Yes it did fianlly. Because the injury is near the joint, a fixation would have served you better.
****************************************************************************************************
So you see the x-ray image… Right now my fingers are stiff and I know it needs therapy. It’s been 4 weeks now. I guess upon researching I found out that this kind of bone healing is a mal-union thing. It was not properly aligned.
What are the effects of a mal-union on my hand? I mean what should I expect? Will this cause me problems in the future? Thanks.
Dr Arun Pal Singh Reply:
November 14th, 2010 at 11:32 am
@Don,
Pain and limitation of the motion in the affected joint are the usual consequences.
The severity of the symptoms vary though with individual.
i broke my wrist (displaced fracture that was reduced and casted) four weeks ago.at the two week appointment ortho said xray looked good.had another appointment two weeks later (yesterday) and ortho decided to recast in long arm due to it being lose and keep me casted for full 6 weeks in a long arm cast (2 more weeks) and i have a few questions.forgot to ask the ortho.(have no xrays, sorry)
1. how likely is it for the bones to shift out of alignment at this stage? and will occasional muscle spasms move them much?
2.my wrist is casted in a bent position.he said it was to help keep the bones from collapsing.
will my wrist be stuck in this position?
when would be a ideal time to straighten it out?
will it hurt as bad as last time (4 week mark) when it was removed from the cast next time?
is a occasional burning sensation normal? i chalk it up as nerves.its not bad but annoying.
i was thinking of asking them if they can just cut this cast down to make a short cast instead of recasting, granted my wrist area will still be tight.i dont want to risk harming the fracture prematurely at my next appointment when i get my short arm cast.
thank you for your time.
Dr Arun Pal Singh Reply:
November 14th, 2010 at 2:00 pm
@sareena,
The fracture usually becomes sticky around 2-3 weeks and with this the mobility of the fragments decrease with passing time.
Do not worry at this time about shift f alignment.
After your plaster is removed, you would be put on physiotherapy which would help you to regain the movements.
whether to shorten the cast or not is a decision that depends on your fractur configuration and healing response.
hello doc, i recently sustained a c2 fracture while in a car accident. i was wondering how long does it take to heal and how long do i have to wear a neck brace. secondly i sufferd a contusion to the elbow with a slight healing fracture, can that cause black blood to appear on my forarm with massive swelling while forming a scab and now from time to time has discharge? is the swelling why i cant bend my arm up to my face?
Dr Arun Pal Singh Reply:
November 14th, 2010 at 2:05 pm
@remita barnett,
A fracture usually would take 6-8 weeks to heal but brace could be advised for a longer period depending on your fracture configuration.
Your forearm looks like having an infection. Get in touch with your physician.
Hello – wonderful website.
I injured my back 5 weeks ago by carrying a 30 lbs child up an unmarked hiking hill. Felt major “twinge” when I shifted the child from hip to hip. Since then, have been suffering with pain similar to the classic symptoms of sciatica: shooting pain down the back of my left leg, occasional numbness and tingling down my left leg and through my left buttocks. I absolutely cannot sit down for any length of time as that will completely exacerbate the problem, but I can stand and walk for hours on end without a problem.
Had an MRI that only shows swelling at the tip of my spinal cord (conus medullaris). Very happy I did not rupture a disc. Now into my 5th week, the pain seems to be concentrating in my lower back and vary rarely are there shooting pains down my leg. I am careful not to do anything to tweak or shift my back in any way to cause further pain. Tried physical therapy (ultrasound, heat, electric stim) but it does nothing to help. Ibuprofen provides no relief.
How long does it take for swelling of the conus medullaris to settle down and go away? Scheduled to see a neurosurgeon at the end of January but hoping it will go away before then. Thank you.
Dr Arun Pal Singh Reply:
November 27th, 2010 at 7:28 am
@Ann,
Why should there be a swelling of Conus Medullaris?
It is not usually seen and it cannot result from the strain that you describe.
My Husband is 27 year old. He is suffering from Bone Tuberculosis detected recently. As per Doctor, the disease has not affected his nervous system yet. Doctor prescribed him medicine of 6 months. Some people are saying that Bone Tuberculosis does not heal fully. There is chance of lead a good time in bed. How true it is? I am very tensed, can you please clarify? And what can I do?
Dr Arun Pal Singh Reply:
November 27th, 2010 at 7:30 am
@Sadia Naznin,
Please follow your doctor’s advice and support your husband. Take care of his hygiene and nutrition so that he has enough strength to resist the disease.
Hi Dr.
Replying to your reply below. Actually I saw a specialist about this a week and a 1/2 ago. He is telling me I broke cartilage on my talus mainly, not so much a bone fracture. He told me there may be a small bone chip & to start walking on it (he told me I have the leg bones of an old women for staying off it for so long) with 2 crutches, then 1, then working my way to without any support. He has me doing the ABC’s with my foot vigorously to get mobility back. Eventually he wants me to get to the point where I can do calf raises.
I was told there could be swelling for up to a year, and that I may have long term pain. I am going back in a week and 1/2 for a follow up and possible MRI. The Dr. said it may be possible to perform a surgery to tack the loose cartilage back on but it is difficult to do and may not be necessary. He doesn’t think I tore or ruptured any tendons but there is a lot of swelling still around my ankle joint especially near the achilles heel.
Right now I am walking with a cane. There is a lot of pain when I walk on it everywhere in my ankle & foot, not just where the cartilage damage is and the swelling is causing my flexibility in my ankle/foot to be limited. There is no pain when I am sitting or moving it around doing the ABC’s, just when I walk on it. What I am wondering is what is the approx. time it may take until I am fully mobile & can run, train in martial arts etc. & when can I expect my ankle swelling to go down to where it looks like my other ankle? Again it’s been about 3 months 2 weeks since my accident.
I can send you the x-ray, just not sure how to attach it to this post. Please let me know, thanks!
Tom
Tom says:
October 27, 2010 at 11:16 pm
Hi Dr.
I sprained my ankle from a fall ( I jumped off a high deck in the dark) & was examined with a nondisplaced oblique fracture on the most lateral aspect of the dome of the talus. The tibiotalar joint is intact, there is lateral soft tissue swelling. I am a 32 year very active male.
So I got an x-ray 7 weeks later as a follow up and the x-ray came up unchanged. These were seen by 2 separate radiologists. I got an a opinion from an orthopedic Dr. a few days ago who looked at the x-rays and said there is healing occuring although he feels there may be a trimalleolar fracture and maybe a ruptured tendon. He said he does not think that surgery is needed, if anything to clean things up but that he does not feel that’s necessary since things look okay and that I am doing what I need to be doing staying off of it.
He recommended getting a cam walker or air boot to put my foot in.
He also said that I would have pain for 6 – 12 months but did not give me a time frame for complete healing. Also, I was told not to weight bear (which I have not, I’ve been in a splint and on crutches for almost 8 weeks now) but that I should start moving the ankle around like doing the ABC’s to prevent fibrosis. I am going to another orthopedic Dr. in 2 weeks for another x-ray and get a second opinion.
I just want to get your opinion on how long healing may take until I am 100% & the fact that what I am reading about trimalleolar fractures (if that’s what I have) usually require surgery.
Thanks, I appreciate your feedback.
Tom
Dr Arun Pal Singh Reply:
November 10th, 2010 at 10:34 pm
@Tom,
It is difficult for me to commend on your situation as I d not have the complete info.
In fact what you say is bit confusing.
First you mention that it was talar dome fracture. I do not think that can be confused with trimalleolar fracture as both the fractures involve different bones.
Can I look at the xray?
Dr Arun Pal Singh Reply:
November 27th, 2010 at 1:03 pm
@Tom,
You can send the xray to contact [at] boneandspine [dot] com.
Hello Dr Arun
I slipped in the office and had a fracture on the Ankle bone (fibula) on 12 October 2010, my Dr has asked me to get several x-rays to see if the bone has moved or not. Since the space between the bone has become less the Dr let me start walking from 14 November 2010. i have been walking ever since. I wanted to know about the burning sensation that i get (i walk with the fibreglass cast, but the cast isn’t tight its comfortable for me) is it normal? what does the burning sensation here mean?, when will i be able to walk with out the cast?, will i be able to run or even jump anywhere sooner? Can i carry my 1 year old son n walk? can i carry any weight n walk(House work)? how long does it take to HEAL ?
Appreciate if you could reply with the answers
Thanks
Dr Arun Pal Singh Reply:
December 4th, 2010 at 1:37 pm
@Evon,
By this time, your cast would have been removed. How are you?
I am a 54 year old woman with a non-displaced spiral fracture of the fifth metacarpal of my right (dominant) hand. Injury occurred Oct. 2 or nearly 8 weeks ago. Spent 3 weeks in plaster splint, then fingers were buddy taped two weeks. X-ray at 7 weeks still showed black line and no visible healing. PA prescribed hand therapy for range of motion in fingers but exercises have increased soreness and swelling. Joint of fifth finger is stiffer and inflamed. Should I get a second opinion or is this normal healing process?
Dr Arun Pal Singh Reply:
December 4th, 2010 at 4:36 pm
@Debbie,
If you wish, you can get a second opinion. But spiral fracture, that too undisplaced should heal without problems.
A radiolucent line may persist for longer though.
Was joint involved initially?
i had a fracture in my right ankle.both the lower portions of tibia and fibia were broken.doctor made a cast and yesterday after 38 days the cast was removed.i want to know about the recovery time and what else i can do to start walking again and any other thing i can do for my treatment?
Dr Arun Pal Singh Reply:
December 4th, 2010 at 4:37 pm
@himanshu bohra,
What did your doctor tell you? How are you doing right now?
Hi doctor., I have a fracture in 2 and 3rd metatarsal, and xrays and doctor confirmed, it is not displaced. Just a break and doctor had said it will take 3-4 weeks to heal… but on browsing the internet am really afraid, whether am in for a long haul… pls advice me regarding the healing time…
It has been 7 days since the fracture, and i tried to move the fractured leg slightly, i walked around 4 to 5 feet, slowly with slight pain, and again i shifted back to my crutches.. I would like to know, by walking whether i would have done more damage to the fractured area or walking slowly for 3 to 4 feet daily is not a problem? IAppreciate your inputs..
Dr Arun Pal Singh Reply:
December 14th, 2010 at 2:51 pm
@Narayanan,
You should avoid walking for initial 2 weeks. You could walk on your heel. It is easier and weight is not distributed on the injured area.
can a fractured back bone affect u getting pregnant
Dr Arun Pal Singh Reply:
December 14th, 2010 at 2:55 pm
@shari,
You need to elaborate your problem. Too little info here and too generalised.
Hi Dr. Singh:
As a follow up to my original MRI, I received my radiology report which indicates the following…
FINDINGS: Sagittal sequences extend superiorly to the T10-T11 level. The 6mm x 6mm intradural lesion near the tip of the conus at the inferior aspect of the L1 level demonstrates fairly homogeneous enhancement. No other enhancing conus or spinal canal lesions are identified. There are no bony destructive lesions.
IMPRESSION: 6 x 6mm intradural enhancing lesion near the tip of the conus. The leading differential considerations include ependymoma, nerve sheath tumor, and meningioma.
My doctor is setting me up with a neurosurgeon. First available appointment is January 31, 2011. I was considering canceling since the pain and symptoms are really subsiding finally, but now knowing there is the possibility of a tumor, I’m going to keep the appointment.
I’m now wondering if the tiny tumor has caused my sciatica symptoms in recent years…and maybe carrying the child up the hill in October really brought out the sciatica….and finding the 6mm x 6mm lesion on the MRI pictures was just pure coincidence.
Any thoughts?
Here was my original issue:
I injured my back 5 weeks ago by carrying a 30 lbs child up an unmarked hiking hill. Felt major “twinge” when I shifted the child from hip to hip. Since then, have been suffering with pain similar to the classic symptoms of sciatica: shooting pain down the back of my left leg, occasional numbness and tingling down my left leg and through my left buttocks. I absolutely cannot sit down for any length of time as that will completely exacerbate the problem, but I can stand and walk for hours on end without a problem.
Had an MRI that only shows swelling at the tip of my spinal cord (conus medullaris). Very happy I did not rupture a disc. Now into my 5th week, the pain seems to be concentrating in my lower back and vary rarely are there shooting pains down my leg. I am careful not to do anything to tweak or shift my back in any way to cause further pain. Tried physical therapy (ultrasound, heat, electric stim) but it does nothing to help. Ibuprofen provides no relief.
How long does it take for swelling of the conus medullaris to settle down and go away? Scheduled to see a neurosurgeon at the end of January but hoping it will go away before then. Thank you.
Dr Arun Pal Singh Reply:
November 27th, 2010 at 7:28 am
@Ann,
Why should there be a swelling of Conus Medullaris?
It is not usually seen and it cannot result from the strain that you describe.
Dr Arun Pal Singh Reply:
December 4th, 2010 at 1:34 pm
@Ann,
Yes! It could be both ways. But a lesion should not be ignored even if it has come as incidental finding.
All the best.
Thank you so much for this article, it was very informative. My 3 year old son broke both the bones in his right leg, about an inch or two above the ankle. he was sedated for realignment and was in a full leg cast for 7 weeks (no pins or anything). the cast removal took over 30 minutes (with him screaming in pain the whole time) and his foot and ankle were badly bruised. The x-rays, according to the orthopedic specialist, showed “90% healed”, but now, 6 days after the cast was removed, he is still refusing to walk or even stand, and if we try to make him, he screams that it hurts (even though we are supporting most of his weight). He’s able to scoot around and climb on the furniture but he’s favoring that leg. Should he still be in pain at this point? I’m starting to get very concerned that something is wrong… thank you for your time.
Dr Arun Pal Singh Reply:
December 4th, 2010 at 1:32 pm
@Ashley,
Generally, by this time, there should be no pain. If there is radiological union as your doctor has suggested, there should not be problem in weight bearing.
But because he is too young, most likely he remembers the pain that he had when the injury occur.
Children tend to remember the trauma and refuse to use the limbs.
However if there is no improvement over one week, you can get him to the doctor again.
Try comforting him and make him understand that it would not pain. {But confirm first that pain is not there}
Hello doctor,
, fracture happened to be at the base of 2nd and 3rd metatarsal (not displaced).. Is it a Lisfranc fracture? am not that much of physically active person.. will i ever be able to walk again in my life?
Dr Arun Pal Singh Reply:
December 4th, 2010 at 1:27 pm
@Narayanan,
Base fractures are not Lisfranc, if you are correctly describing your injury.
Did you take treatment?
Metacarpal fractures heal well and usually do not cause problems.
Hello Dr!
I fell down, twisted my ankle and the result is a fracture on the 4th metatarsal. It has been 5 weeks now, I went for an X- ray yesterday and the doctor told me healing process has started. He asked me to come back after 2 weeks. Doctor gave me a boot instead of plaster. I am worried if it is slowing the healing process. Can you please tell me if the boot is as good as the plaster?
Dr Arun Pal Singh Reply:
December 14th, 2010 at 3:29 pm
@Sathish,
It should do fine. It would not slow the healing process.