A radiologist! There are all kinds of benefits of the arborist forum. The other two shots are below Dan.Sorry to hear about your predicament Blue42. I am just seeing this post now after a long hiatus from arborsite, lolz. I do this stuff for a living, that is, radiography for a major Boston hospital.
As you already know now standard course of care would be xrays, reduction, splint, and surgery if reduction is not good enough. Wrt to long bones and major joints there is a greater probability of long term damage if not addressed quickly.
Metacarpals, metatarsals and other mostly static bones can have some distortion and you will love a long healthy life. You can’t really reduce those fx’s well as there are other fixed bone positions around the spot. You can press and twist a bit to get it in a better position but sometimes you need surgical intervention
I would like to see the lateral view to better assess distraction of the proximal and distal pieces. It looks like the surgery was indeed called for looking at that AP view. Urgent care centers are for quick and dirty fixes and if evident a transfer to a major hospital is warranted.
That being said, since I’ve been doing this for over 20 years I’ve learned you have “shop” smart with your healthcare when you can since there are a lot of MD’s out there still learning or not specialized as well as mid-level practitioners taking the frontline.
Tissue necrosis is a serious thing. I would make sure that is addressed pronto. A small liss plate with 5-6 screws would do well to fix that fx.
Ive just cut the string to my thumb 9 weeks ago, Im sharpening everything. 12 weeks I may apply full load.Funny question for the arboristsite but someone I hope will know. I broke my hand it today punching something. The fourth metacarpal broke all the way through. I went to Urgent Care and they put a makeshift cast on it but the nurse practitioner didn't even try to get the bones aligned. The X-ray showed that the bone was not aligned at all. I asked if it was worth trying to align the bones and he said it was not worth it and that the tendons and muscles would pull the bones back into place. Does anyone have any experience with this? I could freaking pull the bone out myself and get it straighter than it was on the X-ray. When I first broke it I actually moved it into a better place than it was originally.
It concerns me just letting the thing sit and maybe heal up all crooked when a simple pull and set might have gotten it much better.
I have to go to an orthopedist next week and I'm sure he'll do what needs to be done. But I just wonder why the heck in the meantime we would just let it sit crooked. I'm kind of suspecting the Urgent Care place just wanted to patch it up and pass the buck on to the orthopedist.
At this point just deal with it as bone will grow around the site creating a solid mass over time. That first pic you added in your post a few weeks ago was the oblique view. The views you added do show some displacement though not severe. Again, be wary of your skin condition and don’t keep compression on too long. Will surgery help or hurt at this point? IDK. The Ortho surgeon would dissect down to bone and put a plate in with about 6 screws. It would straighten that metacarpal out but you gotta make that decision. Most important decision is to mitigate pain and discomfort but if you feel better and pain subsides with time leave it be. You will be fine going forward as the fx does not involve a joint space. When a fx compromises a joint space you will most definitely have osteoarthritis in the future. Those fx’s cannot be ignored. I had a spiral fx of my tibia years and years ago. Didn’t need ORIF and there is a large growth of bone mass around the site after I checked it with imaging about 6 years later.A radiologist! There are all kinds of benefits of the arborist forum. The other two shots are below Dan.
At this point they'd have to hit it with a hammer to move it. It isn't crackling around anymore when I push on it. Or I could do it in my garage. I wish I could get another shot at it myself with a decent brace. I bet I could have gotten it to heal a lot straighter.