I've moved my blog to a new site. Please follow me here!
http://micheledarwin.posterous.com/
Wednesday, January 26, 2011
Wednesday, January 5, 2011
Tuesday, December 28, 2010
30 weeks, or 212 days later - I'm a PT graduate!
I was officially released from PT today! Let's check the progress:
Elbow extension: 8 degrees
Elbow flexion: 133 degrees *
*back to the range of motion I had after my severe injury at age 13
Wrist flexion: 72 degree
Wrist extension: 80 degrees
I came home with a fresh container of green putty to help me continue to strengthen my grip and the coveted C.O.R.E t-shirt that I will wear proudly. I can not thank my therapist enough for all of her help and support. This injury is really difficult to explain and can be utterly frustrating at times. I am so grateful for the amazing team that I had getting me through this!
Elbow extension: 8 degrees
Elbow flexion: 133 degrees *
*back to the range of motion I had after my severe injury at age 13
Wrist flexion: 72 degree
Wrist extension: 80 degrees
I came home with a fresh container of green putty to help me continue to strengthen my grip and the coveted C.O.R.E t-shirt that I will wear proudly. I can not thank my therapist enough for all of her help and support. This injury is really difficult to explain and can be utterly frustrating at times. I am so grateful for the amazing team that I had getting me through this!
Tuesday, December 21, 2010
And the magic number is ...
I wondered what the magic number would be with regards to the months waiting to see if my thumb starts working like the rest of my fingers. The answer? 7. For seven months I have been watching in amazement as my radial nerve heals itself. I say in amazement because it is truly fascinating. There have been odd tinges, moderate and severe pain, discoloration, swelling and too many other odd things to count. I know that each and every thing that is happening is for a reason. The biggest thing that I notice now is that my arm is starting to feel like it is mine. I have spent months feeling like the arm attached to my body belonged to someone else. I don't really know how to explain it, but my brain just didn't treat it the same. I imagine that since the nerve is now healed at least 7" down my arm, at each major milestone the communications from the brain get better.
My thumb is starting to wake up and feel like it belongs, too. I still have a good bit of numbness on the surface of my hand and I'm not sure if that will ever go away, but I can move the thumbs in ways that I have not been able to in the past. It still feels like the tendons were replaced with tight rubber bands. I can't quite extend completely, and although I can make a fist, it is very tight and stiff.
I know that there are still several months of healing left and perhaps the tightness will ease up and I won't have to think so hard when trying to move my thumb. Until then, I will sit back in awe of the human body and it's magical healing powers and dream of the day I muster up the courage to get back on my bike.
My thumb is starting to wake up and feel like it belongs, too. I still have a good bit of numbness on the surface of my hand and I'm not sure if that will ever go away, but I can move the thumbs in ways that I have not been able to in the past. It still feels like the tendons were replaced with tight rubber bands. I can't quite extend completely, and although I can make a fist, it is very tight and stiff.
I know that there are still several months of healing left and perhaps the tightness will ease up and I won't have to think so hard when trying to move my thumb. Until then, I will sit back in awe of the human body and it's magical healing powers and dream of the day I muster up the courage to get back on my bike.
Monday, December 13, 2010
Fractured humerus .. the gift that keeps on giving!
What a lovely shade of blue, don't you think? Just when I thought that my hand was healing and I was getting back to "normal" I started having some pain and then my hand started to turn blue. I must admit that I was quite discouraged because it feels like a set back and I was enjoying moving forward. The poor color hasn't been a problem for weeks so it was not what I wanted to see.
I called the surgeon and he put my mind at ease. I emailed the photo for him to look at because when I told him during my last office visit the color was great. I guess I wanted him to see what I was referring to. He isn't concerned. He still believes it is a problem with the vessels, a possible side effect of certain type of nerve injuries. There is nothing to be done about it and nothing to worry about. I certainly wasn't expecting anything to be done about it, but I just thought it may be the sign of something that wasn't good since it has been so good for at least a month. "Nothing to worry about." Whew! I'll take that.
This time I did notice something that I don't remember from before. When the pain eased up, the color returned to normal. In the past when my hand started turning blue it was when I was running and I don't remember any specific pain, but then again - it was all hurting! The pain was a burning sensation under my incision area, above the elbow and the entire arm just felt really strange. Interesting ... Weird.
Every day is a learning experience!
I called the surgeon and he put my mind at ease. I emailed the photo for him to look at because when I told him during my last office visit the color was great. I guess I wanted him to see what I was referring to. He isn't concerned. He still believes it is a problem with the vessels, a possible side effect of certain type of nerve injuries. There is nothing to be done about it and nothing to worry about. I certainly wasn't expecting anything to be done about it, but I just thought it may be the sign of something that wasn't good since it has been so good for at least a month. "Nothing to worry about." Whew! I'll take that.
This time I did notice something that I don't remember from before. When the pain eased up, the color returned to normal. In the past when my hand started turning blue it was when I was running and I don't remember any specific pain, but then again - it was all hurting! The pain was a burning sensation under my incision area, above the elbow and the entire arm just felt really strange. Interesting ... Weird.
Every day is a learning experience!
Friday, December 10, 2010
7 months and counting ....
It's been about a month since I last documented my progress. Things have been going well. So well, in fact, that I actually feel like I've made my way out the other side. As I type this post tonight it is with two hands typing. I wasn't sure that would ever happen just a couple of months ago. My hand remains swollen and stiff but it works ... it really works!
I continue to have trouble with my thumb and elbow. The thumb is patiently waiting for the radial nerve to heal itself and the elbow is just very stiff and sore. It's not painful, it's just achy ... all the time. I suspect that it is the severe osteoarthritis rearing it's ugly face and I just try to keep it moving as much as possible in hopes that I keep the blood flowing. My hope is that the arthritis will settle down but if not, it's okay. I can use my arm!
The rotation that I have been diligently working to restore has not improved at all. I won't stop working, but I suspect that I will not regain that range of motion. The flexion and extension at the elbow are about the same, too. I secretly hoped that by spending time 7 days a week for 7 months doing PT with my elbow, I could beat the odds given to me from the surgeon. I was told that I should expect to lose 10-15 degrees range of motion both directions due to the plate placement and that is where I seem to be.
I continue to have trouble with my thumb and elbow. The thumb is patiently waiting for the radial nerve to heal itself and the elbow is just very stiff and sore. It's not painful, it's just achy ... all the time. I suspect that it is the severe osteoarthritis rearing it's ugly face and I just try to keep it moving as much as possible in hopes that I keep the blood flowing. My hope is that the arthritis will settle down but if not, it's okay. I can use my arm!
The rotation that I have been diligently working to restore has not improved at all. I won't stop working, but I suspect that I will not regain that range of motion. The flexion and extension at the elbow are about the same, too. I secretly hoped that by spending time 7 days a week for 7 months doing PT with my elbow, I could beat the odds given to me from the surgeon. I was told that I should expect to lose 10-15 degrees range of motion both directions due to the plate placement and that is where I seem to be.
Thursday, November 18, 2010
Tuesday, November 9, 2010
Shocks and needles and electrodes, oh my!
I had a follow-up EMG today. The regeneration of nerves is such a fascinating thing! In fact, the whole human body is fascinating. Bones break and heal, nerves that receive and deliver signals from the brain can just grow back when injured - all right before our very eyes. It's slow, but SO interesting!
My radial nerve was injured above my elbow and in the past 3+ months since my first EMG, it has completely healed to a point below my elbow, about 3-4" worth of regeneration. As I had mentioned in an earlier post, I was told it would grow about 1mm a day, or 1" a month. It has been 5 months since the fracture, so it does appear to be following the "normal" path of recovery.
The muscle that allows us to lift our wrist is high in the forearm, close to the elbow. My wrist is working well and the EMG confirmed that the nerve up into my triceps from this point is completely healed. (music to my ears!) As the nerve travels further down the forearm, it begins to help with the function of the fingers. There are signs of improvement in my 4 fingers, but very little in my thumb. The EMG confirmed this. There are areas of the nerve that are not showing any signal at all. The Dr. is not concerned, she feels that the healing in this area has just not happened yet. She feels that although there is no guarantee, at this point she is confident that it will come back over the next 3-4 months.
I had another milestone - NO MORE DYNAMIC SPLINT! It has served me well! Both the Dr. and the PT agree that at this point it may hinder the strengthening of the muscles and that using my hand in any capacity as much as possible is the best PT of all. I thought that when I was done with this thing I would want to melt it down like the Wicked Witch of the West but in a strange kind of way it signifies a lot and I don't want to throw it away. It kind of represents 5 months of my life this year .... how weird am I?
My radial nerve was injured above my elbow and in the past 3+ months since my first EMG, it has completely healed to a point below my elbow, about 3-4" worth of regeneration. As I had mentioned in an earlier post, I was told it would grow about 1mm a day, or 1" a month. It has been 5 months since the fracture, so it does appear to be following the "normal" path of recovery.
The muscle that allows us to lift our wrist is high in the forearm, close to the elbow. My wrist is working well and the EMG confirmed that the nerve up into my triceps from this point is completely healed. (music to my ears!) As the nerve travels further down the forearm, it begins to help with the function of the fingers. There are signs of improvement in my 4 fingers, but very little in my thumb. The EMG confirmed this. There are areas of the nerve that are not showing any signal at all. The Dr. is not concerned, she feels that the healing in this area has just not happened yet. She feels that although there is no guarantee, at this point she is confident that it will come back over the next 3-4 months.
I had another milestone - NO MORE DYNAMIC SPLINT! It has served me well! Both the Dr. and the PT agree that at this point it may hinder the strengthening of the muscles and that using my hand in any capacity as much as possible is the best PT of all. I thought that when I was done with this thing I would want to melt it down like the Wicked Witch of the West but in a strange kind of way it signifies a lot and I don't want to throw it away. It kind of represents 5 months of my life this year .... how weird am I?
Sunday, November 7, 2010
Time keeps on ticking ....
Holy cow! The progress over the past 7 days has been remarkable. The muscles are getting stronger every day and it feels really great.
I had my 5 month follow-up with the surgeon and he would like me to have another nerve conductivity test, scheduled in two days. I'm not completely sure I understand why this is necessary since it does seem to be healing, but I am interested in seeing what they say with regards to my thumb. My hope is that this will be able to either confirm that the healing radial nerve is growing back as it should, or if there is anything questionable going on.
We discussed the concern I have about the poor color in my hand and he assures me that there is no direct relationship between the radial nerve and the circulation. Both he and the physical therapist say that the small vessels are just not having the blood pushed through as they should because of the weakness in the muscles. I explained to him how blue it looks at times, especially after I have been running and I'll mention it to the Physiatrist when the EMG is done, but I am not going to worry about it at all since my Dr. isn't. Whew!
My next follow-up with the surgeon is in 3 months. Woo hoo! I've graduated from 6 week follow-ups to 12! :)
I'm feeling great! Am now running 5 days a week and did a 5k this past weekend. I have to say that between the chilly air and the arm, running does irritate my shoulder, but it's just great to be heading in the right direction and I am very close to feeling 100% recovered! My hand will come back when it's ready, until then I just want to keep moving and feeling great. Again I am extremely grateful for the surgeon, physical therapist and the most amazing and supportive friends!
I had my 5 month follow-up with the surgeon and he would like me to have another nerve conductivity test, scheduled in two days. I'm not completely sure I understand why this is necessary since it does seem to be healing, but I am interested in seeing what they say with regards to my thumb. My hope is that this will be able to either confirm that the healing radial nerve is growing back as it should, or if there is anything questionable going on.
We discussed the concern I have about the poor color in my hand and he assures me that there is no direct relationship between the radial nerve and the circulation. Both he and the physical therapist say that the small vessels are just not having the blood pushed through as they should because of the weakness in the muscles. I explained to him how blue it looks at times, especially after I have been running and I'll mention it to the Physiatrist when the EMG is done, but I am not going to worry about it at all since my Dr. isn't. Whew!
My next follow-up with the surgeon is in 3 months. Woo hoo! I've graduated from 6 week follow-ups to 12! :)
I'm feeling great! Am now running 5 days a week and did a 5k this past weekend. I have to say that between the chilly air and the arm, running does irritate my shoulder, but it's just great to be heading in the right direction and I am very close to feeling 100% recovered! My hand will come back when it's ready, until then I just want to keep moving and feeling great. Again I am extremely grateful for the surgeon, physical therapist and the most amazing and supportive friends!
Wednesday, November 3, 2010
... And we have LIFT off!
22 weeks has brought me some great progress! I am able to lift my fingers!! Yay! The next step will be the ability to straighten my fingers. I think the hand deserves a little TLC in the way of a manicure!
Sunday, October 31, 2010
If you can't beat 'em, join 'em!
October 31, 2010
When you have two children who are away at college and a high school freshman, Halloween just isn't quite the same. Yes, I put out some festive decorations for my home and put pumpkins on the front porch, but costumes ... not so much! But, WAIT! What if I dress up for Halloween myself? No, that really isn't my thing either.
I stopped by my old office this week to assist them in a project and one of my friends asked me if she could play the strings on my contraption like a guitar. It isn't the first time I have been asked that, so in the spirit of Halloween, and my continuing journey of retaining my sense of humor, I turned my contraption into a guitar. Happy Halloween!
When you have two children who are away at college and a high school freshman, Halloween just isn't quite the same. Yes, I put out some festive decorations for my home and put pumpkins on the front porch, but costumes ... not so much! But, WAIT! What if I dress up for Halloween myself? No, that really isn't my thing either.
I stopped by my old office this week to assist them in a project and one of my friends asked me if she could play the strings on my contraption like a guitar. It isn't the first time I have been asked that, so in the spirit of Halloween, and my continuing journey of retaining my sense of humor, I turned my contraption into a guitar. Happy Halloween!
Friday, October 15, 2010
Month 5 ... let's check the progress!
Well, it's been 7 weeks since I had measurements at PT. The entire time with my physical therapist has been spent working on range of motion in my shoulder so all of the range of motion work on my elbow has been left up to me. Have I done the job? Let's check the progress:
Extension: 8 degrees / 4 degrees with assistance. 4 degree improvement since last measurement, 32 degrees overall! I was told that I would probably never get more than 10 - 15 degrees because of the placement of the plates. Ha! No one should tell me I can "never" do something because that just makes me fight harder. I hope that when my triceps returns after the radial nerve fully heals, I will get my arm completely straight.
Flexion: 134 degrees with or without assistance. 10 degree improvement since last measurement, 34 degree improvement overall! I'm afraid this may be the extent of my ability to bend at the elbow because even the PT can not push it even one degree further. I believe I am right at the range of motion I had prior to my fracture, although I never had an official measurement after all of my surgeries as a child. I will keep working on this!
Nothing new with the fingers, so hopefully I will have an update to report soon!
Extension: 8 degrees / 4 degrees with assistance. 4 degree improvement since last measurement, 32 degrees overall! I was told that I would probably never get more than 10 - 15 degrees because of the placement of the plates. Ha! No one should tell me I can "never" do something because that just makes me fight harder. I hope that when my triceps returns after the radial nerve fully heals, I will get my arm completely straight.
Flexion: 134 degrees with or without assistance. 10 degree improvement since last measurement, 34 degree improvement overall! I'm afraid this may be the extent of my ability to bend at the elbow because even the PT can not push it even one degree further. I believe I am right at the range of motion I had prior to my fracture, although I never had an official measurement after all of my surgeries as a child. I will keep working on this!
Nothing new with the fingers, so hopefully I will have an update to report soon!
Thursday, October 14, 2010
Blast from the past .....
Early on in my posts I mentioned the fact that I suffered a severe injury to the same arm when I was 13 years old. I had several surgeries and have often wondered about the surgeon who fixed my arm the first time around.
I grew up in Maryland and I remember the physician left his practice shortly after he treated me to move back to his home land of Israel. Last night I was on PubMed looking for articles related to circulation issues after a fracture and radial nerve palsy. I didn't find what I was looking for but I did find an article about humerus fractures that cited a Dr. Edelson in Israel. I sent him and email and within an hour I had a reply - it was the orthopaedic surgeon who treated me in the 1970's. How great is that?
Random little story, but it made my day!
I grew up in Maryland and I remember the physician left his practice shortly after he treated me to move back to his home land of Israel. Last night I was on PubMed looking for articles related to circulation issues after a fracture and radial nerve palsy. I didn't find what I was looking for but I did find an article about humerus fractures that cited a Dr. Edelson in Israel. I sent him and email and within an hour I had a reply - it was the orthopaedic surgeon who treated me in the 1970's. How great is that?
Random little story, but it made my day!
Tuesday, October 5, 2010
... and YES, my wrist is getting stronger!
September 11 was the last date I posted photos. Today is October 4 and I decided to look back on those images to see if there has been any progress. I'm glad that I keep images because it may not be much, but the wrist is stronger! My pointer finger has more muscle tone but the other 4 fingers have not improved at all. Yet. I know their days are coming!
When my hand is flat on the table I still can not lift any of my fingers. There just is not enough strength for that ... yet. I can, however, lift my wrist and that is progress!
Thanks to my new iPhone I am able to take video. This is what it looks like to have a wrist that works, with a hand that does not. Because the pointer finger has gained some muscle tone, I am actually able to lift it with the wrist at certain positions. Yay! However, when I try to lift the other fingers - or all 5 at the same time, it is clear that I have a long way to go!
 |
| tiny improvement, but see a small amount of flex at the wrist! |
When my hand is flat on the table I still can not lift any of my fingers. There just is not enough strength for that ... yet. I can, however, lift my wrist and that is progress!
 |
| I can lift my hand at the wrist when flat on the table! |
Friday, September 24, 2010
Oh, frozen shoulder!
Great new! No surgery is needed on my shoulder. Whew! I was NOT looking forward to dragging this out one minute longer than necessary and I can't imagine starting all over with another surgery.
So, what is causing me all the trouble, you ask? Frozen Shoulder, otherwise known as adhesive capsulitis.
In the case of me, they believe it was from the high impact fall when I fractured my arm. My MRI impression reads:
Unfortunately, it takes a long time to regain range of motion after frozen shoulder, but I am reminded to be a "patient" patient. I'm waiting for the radial nerve so I'll wait for the shoulder to show me some love, too.
So, what is causing me all the trouble, you ask? Frozen Shoulder, otherwise known as adhesive capsulitis.
- Extensive adhesive capsulitis with pericapsula edema and capsualar thickening
- Mild acromioclavicular osteoarthritis
- Moderate subacromial and subdeltoid bursitis
- Low-grade inrerstitial and possible bursai surface partial tear far anterior supraspinatus tendon
- Degenerative glenoid labrum and tendinosis of the extracapsular biceps tendon
Unfortunately, it takes a long time to regain range of motion after frozen shoulder, but I am reminded to be a "patient" patient. I'm waiting for the radial nerve so I'll wait for the shoulder to show me some love, too.
Monday, September 20, 2010
16 weeks ... let's check the progress!
Today was another follow up and things are going really well with the fracture. The bone continues to heal well and x-rays show new bone growth which is always what you want to see. It's hard to see the fracture line in the original x-ray with all of the hardware but I am reminded again of what a terrible location the humerus broke.
The Dr. is really happy with the recovering radial nerve. The wrist continues to get a little stronger each week and now I patiently wait for the fingers to follow! There was a resident from University of Iowa in the office today so much of my visit was spent educating him about the injury I had and the healing process. I really like teaching moments because I always learn a little bit more, too.
My surgeon told the resident that he didn't remember the radial nerve showing signs of injury in the ER and the location of the fracture is not indicative of a radial nerve injury so he feels that the multiple surgeries in my arm as a child and scar tissue may have contributed to the trauma on the nerve as it was moved out of the way while they repaired the injury. We will never know but it is very unusual for this particular fracture. In fact, I was reading an article that said this type of fracture in adults is very unusual, too. Like everything else with me -- it's "uncommon." Shocker. :)
So, now we try to figure out how to best heal the shoulder. One MRI with contrast, one more follow up and one cortisone injection ..... never a dull moment! We will meet and discuss only the shoulder one week from today.
 | ||||
| the pink line represents the fracture - what a mess! |
My surgeon told the resident that he didn't remember the radial nerve showing signs of injury in the ER and the location of the fracture is not indicative of a radial nerve injury so he feels that the multiple surgeries in my arm as a child and scar tissue may have contributed to the trauma on the nerve as it was moved out of the way while they repaired the injury. We will never know but it is very unusual for this particular fracture. In fact, I was reading an article that said this type of fracture in adults is very unusual, too. Like everything else with me -- it's "uncommon." Shocker. :)
So, now we try to figure out how to best heal the shoulder. One MRI with contrast, one more follow up and one cortisone injection ..... never a dull moment! We will meet and discuss only the shoulder one week from today.
Saturday, September 11, 2010
15 weeks .. but who's counting?
Unless you experience this type of injury it's a bit difficult to explain how .. s l o w.. the progress can be, but the key word is PROGRESS! It has been 15 weeks and I am finally starting to see some sign of life in my hand and wrist. I can now not only lift my wrist, but I can flex it back a little and lift my pointer finger, too!
The finger is very interesting. I can lift it if I have some bend in the hand, but there is nothing happening if my wrist/hand are flat on the table.
The tops of my knuckles are really red and inflamed .. another little thing I expected to improve but doesn't ever seem to change. Now that I have a little more strength in the wrist I try to wear my dynamic splint a little less and try to use my hand in hopes of getting some blood flowing and hopefully the swelling will improve.
The finger is very interesting. I can lift it if I have some bend in the hand, but there is nothing happening if my wrist/hand are flat on the table.
The tops of my knuckles are really red and inflamed .. another little thing I expected to improve but doesn't ever seem to change. Now that I have a little more strength in the wrist I try to wear my dynamic splint a little less and try to use my hand in hopes of getting some blood flowing and hopefully the swelling will improve.
 | |
| If I put my hand flat on the table and try to lift my finger .. nothing! I can lift my wrist, so my guess is that I just need to continue to be patient and it will start working! |
Saturday, September 4, 2010
The power of positive thinking .. and a little help from your friends!
I've been told that I can obsess. I choose to believe that I simply crave information. This is my body and I want to understand exactly what is going on. The way I look at it, I can spend a lot more time on my "case" than my physician can. Heck, I only have on patient: ME! At the same time, I have learned from other experiences in the medical world that it is not an exact science and I appreciate that. I am fortunate to have the time and desire to learn.
I think it is important to listen to my doctor and physical therapist and do exactly what they tell me, but I am choosing to take that extra step and educate myself. The funny thing about Radial Nerve Palsy is that I can find a lot of medical articles discussing the "science" behind it, but what has been far more helpful is sharing with other patients who have had similar injuries. In fact, it's been amazing! Everything is so much better with help from your friends and I have met two amazing people ... enter Paul and Laura! Paul (from the UK) is ahead of me in his recovery and Laura (from VT) fractured her arm about 8 weeks ago. I have gotten great tips from both of them and have been able to share what works - and doesn't for me - and I wouldn't trade it for the world. THANK YOU both :)
I think it is important to listen to my doctor and physical therapist and do exactly what they tell me, but I am choosing to take that extra step and educate myself. The funny thing about Radial Nerve Palsy is that I can find a lot of medical articles discussing the "science" behind it, but what has been far more helpful is sharing with other patients who have had similar injuries. In fact, it's been amazing! Everything is so much better with help from your friends and I have met two amazing people ... enter Paul and Laura! Paul (from the UK) is ahead of me in his recovery and Laura (from VT) fractured her arm about 8 weeks ago. I have gotten great tips from both of them and have been able to share what works - and doesn't for me - and I wouldn't trade it for the world. THANK YOU both :)
Tuesday, August 31, 2010
Perhaps a bit too much information?
I don't know if I'm just weird, but I decided that I wanted to read the actual reports from the x-ray and CT taken in the E.R., so, I stopped by the hospital and picked up copies. I have to say, it is a bit enlightening. The most obvious fact that I take away from these findings are that even though my 30+ year old elbow injury hasn't really bothered me much, it was just a matter of time. Yikes, no wonder the ol' elbow is not liking any part of this .......
X-ray (June 9, 2010)
There is a suprachondylar fracture of the distal left humerus with posterior displacement of the proximal humerus fragment with respect to the distal humerus. Significant overlap of fracture fragments is demonstrated. Fracture line appears to extend into the joint space within the distal humerus but this is difficult to determine with certainty. There is an abnormal appearance of the radial head which appears related to significant degenerative change, A definite fracture line is appreciated. There also appears to be degenerative change in the proximal ulna involving the coronoid with some bony spurring, However, this is difficult to evaluate fully on the limited views obtained. Left elbow joint effusion is demonstrated.
Impression:
1. Complete fracture of the distal left humerus with displacement overlapping fracture fragments in gross deformity at the left elbow.
2. Proximal radius and ulna appear grossly intact but these are limited. Degenerative spurring is suggested.
CT (June 9, 2010)
There is a supracondylar fracture of the distal humerus. The fracture is comminuted and anteriorly displaced by 1 shaft width. In the proximal ulna and radius demonstrate no acute change. However, severe osteoarthritis is noted involving the entire elbow with greater involvement in the radiocapitellar joint. There is joint space narrowing subchondral sclerosis and subchondral cyst formation. Osteophyte formation is present. Multipile intra-articular bodies demonstrated anterior to the radiocapitellar joint and anterior to the coronoid process.
Impression:
1. Comminuted distal humerus fracture with anterior displacement by 1 shaft width,
2. No acute change of the proximal ulna or radius. There is severe elbow osteoarthritis with multiple intra-articular bodies anterior to the radiocapitellar joint and anterior to the coronoid process.
X-ray (June 9, 2010)
There is a suprachondylar fracture of the distal left humerus with posterior displacement of the proximal humerus fragment with respect to the distal humerus. Significant overlap of fracture fragments is demonstrated. Fracture line appears to extend into the joint space within the distal humerus but this is difficult to determine with certainty. There is an abnormal appearance of the radial head which appears related to significant degenerative change, A definite fracture line is appreciated. There also appears to be degenerative change in the proximal ulna involving the coronoid with some bony spurring, However, this is difficult to evaluate fully on the limited views obtained. Left elbow joint effusion is demonstrated.
Impression:
1. Complete fracture of the distal left humerus with displacement overlapping fracture fragments in gross deformity at the left elbow.
2. Proximal radius and ulna appear grossly intact but these are limited. Degenerative spurring is suggested.
CT (June 9, 2010)
There is a supracondylar fracture of the distal humerus. The fracture is comminuted and anteriorly displaced by 1 shaft width. In the proximal ulna and radius demonstrate no acute change. However, severe osteoarthritis is noted involving the entire elbow with greater involvement in the radiocapitellar joint. There is joint space narrowing subchondral sclerosis and subchondral cyst formation. Osteophyte formation is present. Multipile intra-articular bodies demonstrated anterior to the radiocapitellar joint and anterior to the coronoid process.
Impression:
1. Comminuted distal humerus fracture with anterior displacement by 1 shaft width,
2. No acute change of the proximal ulna or radius. There is severe elbow osteoarthritis with multiple intra-articular bodies anterior to the radiocapitellar joint and anterior to the coronoid process.
Wednesday, August 25, 2010
I have a special request
In addition to all that is going on with my elbow and hand, I have been struggling with my shoulder. My physical therapist and I have been discussing it for weeks, and over the last month I have a heat treatment on the shoulder before we start working on my elbow. I have noticed that as the elbow pain is improving, this annoying shoulder is not. So, last week I told the therapist that I had a special request - that we NOT worry about the arm or hand and concentrate on the shoulder because now it is keeping me up at night.
Because of the shoulder pain, I am unable to lift my arm out to the side or over my head. I was given a series of exercises to help stretch my shoulder that I have added to my daily repertoire but unfortunately there is no improvement.
So, today I was told that they suspect I have a torn rotator cuff. Really? They believe that I injured it in my accident but because I have been so focused on the elbow, I just kind of ignored the shoulder. Ugh! That's all I can say!
It actually makes perfect sense. It has bothered me since I was in the hospital. I first noticed that I couldn't lift my arm almost immediately, but I really thought it was because my arm hurt so bad I wasn't really trying. I then spent 6 weeks in a sling where I didn't need to, but still struggled getting dressed.
Next stop: MRI.
Because of the shoulder pain, I am unable to lift my arm out to the side or over my head. I was given a series of exercises to help stretch my shoulder that I have added to my daily repertoire but unfortunately there is no improvement.
So, today I was told that they suspect I have a torn rotator cuff. Really? They believe that I injured it in my accident but because I have been so focused on the elbow, I just kind of ignored the shoulder. Ugh! That's all I can say!
It actually makes perfect sense. It has bothered me since I was in the hospital. I first noticed that I couldn't lift my arm almost immediately, but I really thought it was because my arm hurt so bad I wasn't really trying. I then spent 6 weeks in a sling where I didn't need to, but still struggled getting dressed.
Next stop: MRI.
Subscribe to:
Posts (Atom)