When I broke my wrist last year I thought I had a standard condition. Haven’t doctors been fixing broken bones since Hippocrates? If they can’t get that right, how can they possibly do complicated procedures like organ transplants? I was in for a rude awakening.
I suppose every break is a little different and mine was particularly bad. I broke off the distal end of my radius and shoved the broken shaft of bone into my wrist. My hand twisted and the palm collapsed in on itself. Still, I’d heard of worse. I was in shock when I got to the ER but that doesn’t explain my confidence in the medical profession. Brain washing by such TV shows as ER and Marcus Welby explained that.
It took several months before I realized things weren’t going well. How long does a broken wrist take to heal anyway? My physical therapist recommended a medieval-looking device called a supination split. I was to wear it while sleeping. How could anyone sleep with that contraption of metal, and Velcro wrapped around their arm? You have to be very tired.
Four months of the split convinced my doctor that it wasn’t working. Time to try something new. How about a surgical procedure called a Suave-Kapandji (SK)? How about cutting my ulna in two, pinning the wrist end to my radius and letting the section attached to my elbow just ‘flap in the wind’? “It takes some getting used to,” my doctor said. I was worried. Is it okay for a bone not to be connected to anything on one end? You don’t really need it, the doctor explained, it’s extra like your appendix. Call me skeptical, I decided to get a second opinion.
I went to a doctor recommended by my doctor. You wouldn’t go to your mechanics best friend for unbiased advice would you? I assumed doctors were above that kind of thing. Even so, Dr. #2 did not completely agree with Dr. #1. Could do an SK, he said, or could just cut a section out of the ulna and pin it back together, a procedure called an ulnar shortening.
I needed another opinion, someone who would agree with one of the previous doctors. But Dr. #3 came up with a completely new procedure--radial reconstruction. He would take out the pin Dr. #1 put in, cut the radius apart and restore it to its original length using a bone graft from my hip. I was stunned. How did my hip get involved? Time for another opinion.
Dr. #4 took a cat scan of my wrist. He examined it closely and proclaimed there was nothing wrong that a good shot of cortisone wouldn’t fix. Dr. #1 had already given me cortisone but Dr. #4 said he didn’t do it right. He must not have done it right either because it didn’t work again.
There was only minimal agreement in the diagnosis I’d gotten. Drs #3 and #4 were both adamantly against an SK. Both said an ulna shortening was possible but probably wouldn’t help. Since I didn’t want to spend the rest of my life getting more opinions, I decided to go with Dr. #3. His procedure could be done in two parts, first remove the pin then reconstruct the radius. Removing the pin sounded reasonable.
Dr. #3 examined the cat scan taken by Dr. #4. Diagnostic tests are nice, he said, but have no correlation to symptoms. People with good diagnostics can have debilitating symptoms while people with no symptoms might have terrible diagnostics. Then why do they call them “diagnostics?” They don’t diagnose anything.
During surgery, Dr. #3 noted extensive scaring involving the pin and the tendons and other tissues surrounding it. A week later I was able to rotate my arm freely. Two weeks after that, I got full range of motion back in my thumb. Within two months all of my major complaints were resolved. My doctor expressed surprise but gave me a clean bill of health and discharged me from his care.
Turns out I didn't need a radial reconstruction or ulnar shortening or the horrendous Suave-Kapandji. But I might have had any one of those. In science there's usually a right answer. In medicine you just have to cross your fingers--if you can.
X-Ray of my wrist right after the break.X-ray of my wrist with the pin installed.My pin lying on top of the wrist it once held together. I'm thinking of making it into a bracelet. Me the day I broke my wrist. That "cheese" really helped support my arm so I could sleep.