Metacarpal not healing post surgery

Training
1

At the end of September I had a mountain bike accident and broke 2 metacarpals and 4 ribs. The hand injured was my left hand and I am right handed. Surgery was on Oct 2nd and the placed a plate and screws in my Fifth Metacarpal and used screws alone for my Fourth Metacarpal. I’ve been doing OT for the hand since the surgery and have followed all return to activity guidance. I had a follow-up with the surgeon on Monday as there is an odd to the Occupational Therapist and myself bump on the top of my hand and my ring finger knuckle is depressed. I also have been having random slight pain in my ring finger PIP joint. They took x-rays and my ring finger fracture isn’t healed and has moved 20* since the last x-ray in December.

I got a CT Scan and this is the plain english translation of it per CoPilot:

  1. Fourth Metacarpal (Ring Finger Bone)

    • The fracture is mostly not healed (“mostly ununited”).

    • The bone is still angulated and shows dorsal bowing (bent backward).

    • There is some subtle lucency (a dark area on CT that can suggest loosening) around the distal fixation screw, meaning that screw may be slightly loosening.

  2. Fifth Metacarpal (Pinky Bone)

    • The fracture has been fixed with a plate and screws.

    • It shows partial healing with some new bone forming (“partial bony bridging”).

    • But the fracture is still not completely healed—the fracture line is still visible.

    • No signs of hardware loosening around the plate or screws in the fifth metacarpal.

So I have a follow-up message into the surgeon:

  • What questions should I ask?

  • Has anyone else had non-unions of bones following surgery? What was the course of action afterwards?

  • Is it worth getting a second opinion?

Its been a not great week as diagnosed with an inguinal hernia last Friday. On the plus side my weight is down to my goal weight (185 from 242 when I started dieting), so even if I have to get off the bike for a while, I’ll still be faster this summer then in recent years.

2

I snapped my distal phalanges on my left pointer finger, 2 surgeries and didn’t heal, I could feel it wobble. I fired the surgeon and went to another who was recommended after doing some research. The first was on call at the ER when I cut my finger off, so I was stuck with him initially.

My point: do some research and find a well rated hand surgeon. Good luck. 3 surgeries later it’s only 90% bc it’s such a little bone.

3

The guy was recommended by others. Including those in the medical profession. So I’m not 100% sure its his fault vs bad luck.

4

Can you post the radiologist’s official read of the CT as well as the original CT before surgery?

5

No CT beforehand. Just X-Ray. And I should say I smashed it up pretty good for a relatively low speed crash

CT Scan:

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x-Ray

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6

No advice, but I am also dealing with a non union at the moment. I broke my scapula (or had it broken for me by an inattentive driver…) in August and it has failed to unite. They don’t like pinning my sort of fracture and prefer to leave it to heal naturally but it’s now got to the point where they are going to operate so I get to go back into a sling and do all the rehab again, with the added complication of a bone graft from my hip. And it still might not unite.

7

That sucks. Mine was due to my own inattention. Forgot to click buy on a cart of two helmet lights. So just had on a bar light on first ride at dusk. And it was making me look slightly left unconsciously, so caught the right bar on a tree branch in the tree tunnel. Of course the helmet lights arrived the next day.