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Non-union?

 Poster: A snowHead
Poster: A snowHead
I've had a difficult time with a collarbone break I suffered 2+ year back.

Initially, it was "conservatively" treated (without surgery) because the displacement was small. At the time, I was told the union rate was better than 99% (as I have no known risk factor -- never smoked, non diabetic according to blood work result). And as the bones were only slightly displaced from its original alignment, 95% of people regain full function/strength.

For the 6 weeks following that break, x-ray showed the bones marched steadily towards each other until there's no visible gaps between them. Then I was sent to have physio.

But a year later, although the bone looked to be knitted up in all subsequent x-ray, I was having issues in terms of function. So a CAT scan was ordered, which showed the 2 ends of the bone didn't quite reach each other (at a weird angle that normal x-ray doesn't show)!

So, I was the 1%!!!

The few doctors I consulted disagree on whether it's the non-union, or the position of the "almost union", that were the main cause of my functional deficiency -- substantial (~50%) strength reduction. Electrical stimulate test also show some "retarded nerve activation" which correspond to the area where the bones MAY pinch the nerve.

All of them suggest surgery to reposition the bones back to normal configuration with a plate. All of the surgeons reassured me it's a relatively routine surgery with excellent result for most people. Having done one a couple year back (on the other side of my body) which healed up nicely, I didn't finch on the surgery. Went under the knife a year ago.

Unfortunately, after the bones were re-positioned and plated up, it refused to grow towards each other! (unlike the initial break, which the 2 ends of the bones marched towards each other except until the very last bit, this time, there's no growth of the 2 ends)

The surgeon who did the first surgery recommend a second surgery. This time with bone draft from my hip to fill in the gap between the 2 end of the bone. The only problem I have with that is this time, the surgeon is not nearly as sure of the outcome as the last time! So, if he's sure of it the last time but it didn't work, I have a hard time believing this time will be better.

Trust aside, I asked if there's any risk factor that should be checked off before I blindly go under the knife again. I only got a blank look.

TWO non-union in the same location can't be a coincidence, can it?


Last edited by Poster: A snowHead on Mon 30-04-18 17:08; edited 1 time in total
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@abc, I'd want another opinion.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
under a new name wrote:
@abc, I'd want another opinion.
Done.

Reassured it's the right course of action.

If that fails, last course is vasecularized bone draft.


Last edited by Well, the person's real but it's just a made up name, see? on Sat 12-05-18 17:33; edited 2 times in total
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You need to Login to know who's really who.
@abc, fingers crossed, hope it goes well.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
My youngest had a similar worry of a collar bone non fibrous union, but the scan was clear. He has since suffered Vascular Necrosis of the scaphoid bone after a wrong diagnosis of a break.
The success for a bone graft for that bone was said to be 60%
Once he weighed it all up he decided against surgery, but I Think He is regretting it now. Surgeon couldn't advise either way. There was a chance that the op would delay the onset of wrist arthritis.

Based on his experience for a different bone to yours, but still a joint bone, I would have taken the risk and had the op.
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 You'll need to Register first of course.
You'll need to Register first of course.
@abc, do you smoke? are you taking NSAIDs?
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
@Jonpim, no known risk factor. I'm considered osteopenia. But the surgeon said that only affects potential of new break, not known to affect healing. In any case, there isn't much to be done about it anyway, as I'm not considered osteoporosis.

@Frosty the Snowman, with the mentioning of Vascularized bone draft, I had done some quick google. Scaphoid is one of the bone that's most often mentioned.
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