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  #1  
Old 02-28-2007, 12:04 PM
29car 29car is offline
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Re-breaking a bone. Procedure?

Suppose someone waits too long to get an x-ray, and a broken bone has begun to heal incoreectly. The bone has to be rebroken and properly set.

What is that procedure like? Do they have a sterilized unabriged dictionary they use to bash the finger again, or a surgical hammer and chisel to snap the leg?

I know each bone will be different, but what's the general procedure?
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  #2  
Old 02-28-2007, 12:25 PM
Phlosphr Phlosphr is offline
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Quote:
Originally Posted by 29car
Suppose someone waits too long to get an x-ray, and a broken bone has begun to heal incoreectly. The bone has to be rebroken and properly set.

What is that procedure like? Do they have a sterilized unabriged dictionary they use to bash the finger again, or a surgical hammer and chisel to snap the leg?

I know each bone will be different, but what's the general procedure?
They have a couple nurses, a doc or two and a wooden stick to go between your teeth...

<<<snap>>>


Reset and you are good to go.

just kidding

Last edited by Phlosphr; 02-28-2007 at 12:26 PM..
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  #3  
Old 02-28-2007, 12:32 PM
29car 29car is offline
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Quote:
Originally Posted by Phlosphr
They have a couple nurses, a doc or two and a wooden stick to go between your teeth...
There is no way I'm fitting all of them between my teeth. One doctor maybe, or even a nurse and the stick, but not all five.
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  #4  
Old 02-28-2007, 12:50 PM
WhyNot WhyNot is online now
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Quote:
Originally Posted by Phlosphr
They have a couple nurses, a doc or two and a wooden stick to go between your teeth...

<<<snap>>>


Reset and you are good to go.

just kidding
That's not as far off as you might like to think. It's still a pretty barbaric procedure. Generally, a muscle relaxant/sedative is given first, but it's still grab and yank sharply. (Or, as my nurse friend puts it, "Grab, yank and duck!" Because the patient will take a swing at you.)

The other option is some sort of spatial brace, which is one of those circle and pin looking devices. For some breaks, like fingers, docs will put a brace device on it, and every day you have to twist a knob, putting more pressure on a certain spot until the bone snaps. It can take months this way.

And, of course, there are invasive surgical options, usually when a bone has shattered or recalcified over the ends of a break. They may have to go in there and scrape away the excess calcium deposits before rebreaking and/or resetting the bone. This would be done under general anesthetic, of course.

The moral of the story is don't wait. Go in and get it checked out, because the longer you wait, the more painful and expensive it's going to be to fix.
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  #5  
Old 02-28-2007, 01:06 PM
twickster twickster is offline
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Quote:
Originally Posted by 29car
There is no way I'm fitting all of them between my teeth. One doctor maybe, or even a nurse and the stick, but not all five.
I hope you're planning to stick around at the end of your month -- you are, clearly, One Of Us.
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  #6  
Old 02-28-2007, 01:20 PM
alphaboi867 alphaboi867 is offline
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Quote:
Originally Posted by WhyNot
That's not as far off as you might like to think. It's still a pretty barbaric procedure. Generally, a muscle relaxant/sedative is given first, but it's still grab and yank sharply. (Or, as my nurse friend puts it, "Grab, yank and duck!" Because the patient will take a swing at you.)...
I broke my wrist when I was 13. They had me wait a day after the X-rays to set it and put the cast on because of swelling. The doctor didn't want to have to "put me to sleep" to set it (apparently the quack never heard of a local ). So he just told me to "be a big boy" and "it'll be over quick" and had my mother and a nurse hold me down while he set it (twice, before and after the cast was on). I had my shoes on. The nurse was holding my legs. The second time my right foot got loose and I kicked her in the nose, breaking it. The worst part was she was the mother of one of my classmates.
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Last edited by alphaboi867; 02-28-2007 at 01:24 PM.. Reason: format
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  #7  
Old 02-28-2007, 01:31 PM
SmackFu SmackFu is offline
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The last time I broke a bone, they gave me a morphine IV before setting it.
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  #8  
Old 02-28-2007, 01:35 PM
Anaamika Anaamika is offline
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Quote:
Originally Posted by alphaboi867
I broke my wrist when I was 13. They had me wait a day after the X-rays to set it and put the cast on because of swelling. The doctor didn't want to have to "put me to sleep" to set it (apparently the quack never heard of a local ). So he just told me to "be a big boy" and "it'll be over quick" and had my mother and a nurse hold me down while he set it (twice, before and after the cast was on). I had my shoes on. The nurse was holding my legs. The second time my right foot got loose and I kicked her in the nose, breaking it. The worst part was she was the mother of one of my classmates.
This is making me wanna either cry or hide. *shudder*

29car, I second twickster's hope. That made me <snerk>.
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  #9  
Old 02-28-2007, 02:15 PM
Miss Purl McKnittington Miss Purl McKnittington is offline
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Quote:
Originally Posted by alphaboi867
I broke my wrist when I was 13. They had me wait a day after the X-rays to set it and put the cast on because of swelling. The doctor didn't want to have to "put me to sleep" to set it (apparently the quack never heard of a local ). So he just told me to "be a big boy" and "it'll be over quick" and had my mother and a nurse hold me down while he set it (twice, before and after the cast was on). I had my shoes on. The nurse was holding my legs. The second time my right foot got loose and I kicked her in the nose, breaking it. The worst part was she was the mother of one of my classmates.
Similar story when I broke my tibia at age 12. I broke it just after lunch and didn't go into the emergency room until nearly 10 pm. Why? Because the nurse told my mom on the phone that it might just be a really bad bruise and they could wait until after chores to bring me in. So, around 2 in the morning, after listening to a drunk yell at a nurse for an hour and having had my pants cut off nearly four hours ago, the doctor and a couple nurses come into the room where we were waiting. X-rays were ready, and, yep, it was broken. Hell, I could've told them that -- wasn't anything I hadn't known for the past fourteen hours.

The doctor told my parents to get ready to hold me down, put his hands on my leg, and said, "We'll just put this back in place for ya."

Lift, yank!

I don't know that the bone had begun to knit back together again, but there was definitely a sharp yank combined with a very cranky girl. No food since noon and not even an aspirin for pain, and then this jerk comes in and yanks on my broken leg. I could've thrown a punch if my dad hadn't been holding me down.

Five months later, I got the cast off, just in time to limp around for Christmas.
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  #10  
Old 02-28-2007, 03:31 PM
FordPrefect FordPrefect is offline
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I actually have two stories regarding re-breaking bones.
1) I was six years old, staying at my grandma's house while my baby sister was being born. Wiped out on my bike, landing on my arm. Tried to be tough around my uncles (they were 14 and 16) so my grandma didn't realize that I fractured one of the bones in my forearm until 5 days later. Well, she didn't realize that I had hurt my arm, because had she known that I fractured a bone, what happened next wouldn't have happened.

She took me to a (I'll try to sound this as best I can) crachtmorcher. Basically it is the Mennonite version of the Witch Doctor. An old woman, usually, who has healing hands, but no training whatsoever, and passes herself off as a chiropractor. Everyone knows she isn't licensed, but who cares. Cheap, one of the bunch and usually good at getting farmers back to work. So there I am, having my bone reset by a woman who has no idea it is broken. Or if she did, she never told me.

In the end, I went to the doctor, had a cast put on and he was quite impressed with how well the bone was set (which is why I suspect that old lady knew what was going on)

2) The second tale involves me re-breaking my own bone. Through a tale of woe and misery I managed to shatter the bone in the tip of my right thumb into four pieces. I thought I had just dislocated it, and the doc had me sweating while he tried to relocate it, till my wife stopped him (and my uncles were nowhere to be found). After x-rays and three weeks in a cast, I had X-rays again and one piece was not sitting right. So the doc, with his itty bitty hands tried to break the piece free and reset it. But after reefing on my thumb for a few minutes (and doing nothing) declared that he was done and would cast it again.

While he was mixing the plaster (or whatever) I reset it myself and three weeks later I had a healed thumb
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  #11  
Old 02-28-2007, 03:33 PM
Schuyler Schuyler is offline
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Not much to add, other than to relate an anecdote. When I was a teenager, I broke a knuckle, and the doctor at the clinic just basically slapped an Ace bandage on it. The next week, we went to the "real" doctor, an orthopedist, who wanted to break and re-set it. He said, "I can either give you a local, or you can gut it out (or did he say "be a man"? ) for 5 seconds." Anyway, he basically cranked on my knuckle with his two hands, while talking to my mom, and slooowwwly counted to 5. He put a plaster cast on, and there's very little deformation and pretty much full range of motion. Hope that helps.

ETA: FordPrefect's story is way better - disregard mine.

Last edited by Schuyler; 02-28-2007 at 03:35 PM..
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  #12  
Old 02-28-2007, 05:05 PM
Rysdad Rysdad is offline
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I've occasionally seen procedures in the operating room where bones are being "re-set."

There ain't no "breaking" about it.

If the bones have knitted incorrectly, then the docs will use a saw to separate them. Then they will use screws and plates to keep the bones in proper allignment while it heals again.

Sometimes they do use a sort of cage-like device like WhyNot mentioned above. That's called "external fixation." Interesting contraptions. Stretch a bit here, twist a bit there, and in a few months...good as new. Hopefully.

Last edited by Rysdad; 02-28-2007 at 05:06 PM..
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  #13  
Old 02-28-2007, 07:54 PM
Ike Witt Ike Witt is online now
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Quote:
Originally Posted by SmackFu
The last time I broke a bone, they gave me a morphine IV before setting it.
I've never broken a bone, but when I did dislocate my shoulder they gave me some morphine before trying to put it back. The doctor and an orderly the size of a house couldn't manipulate it back into place. I had to be put under general for it to be re-set.


Quote:
Originally Posted by Rysdad
Sometimes they do use a sort of cage-like device like WhyNot mentioned above. That's called "external fixation." Interesting contraptions. Stretch a bit here, twist a bit there, and in a few months...good as new. Hopefully.
Is that the thing that has little metal shafts poking through the skin? I think I'd rather have a crooked bone than one of those things. Keeping the 'holes' sterile seems like it could be a bit of a challenge. Not to mention the creepy visions running through my mind imagining that getting caught on something.
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  #14  
Old 02-28-2007, 08:48 PM
WhyNot WhyNot is online now
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Quote:
Originally Posted by adam yax
Is that the thing that has little metal shafts poking through the skin? I think I'd rather have a crooked bone than one of those things. Keeping the 'holes' sterile seems like it could be a bit of a challenge. Not to mention the creepy visions running through my mind imagining that getting caught on something.
There's fixation - holding bits of bone in place while they heal from a break, there's gradual correction, where small adjustments are made to gradually move and reshape bone, fascia and ligaments, like in the repair of a clubfoot, and then there's deliberate torsion to rebreak a bone. I don't think the hardware is the same for all three, but it looks like it to a layperson's eyes.

Oh, and yes, the pin sites in a fixation device need to be dressed (cleaned to prevent infection) regularly.

Last edited by WhyNot; 02-28-2007 at 08:49 PM..
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  #15  
Old 02-28-2007, 10:41 PM
Mama Zappa Mama Zappa is offline
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Quote:
Originally Posted by alphaboi867
I broke my wrist when I was 13. .....So he just told me to "be a big boy" and "it'll be over quick" ....The nurse was holding my legs. The second time my right foot got loose and I kicked her in the nose, breaking it. The worst part was she was the mother of one of my classmates.
Jeez-o-flip, alphaboi867, what a ROTTEN thing for you to do.
.
.
.
Couldn't you have aimed a bit better and gotten the quack in the nuts? The nurse was just following orders!! next time, plan things out a bit better and improve your aim, 'mkay?

Quote:
Originally Posted by Miss Purl McKnittington
...
The doctor told my parents to get ready to hold me down, put his hands on my leg, and said, "We'll just put this back in place for ya."

Lift, yank!

I don't know that the bone had begun to knit back together again, but there was definitely a sharp yank combined with a very cranky girl. ...
Your story sounds similar to mine except the doc didn't bother to say Word One to me before that sudden **snap** of the wrist.

Which didn't work.. More xrays, a cast removal (and lemme tell you, when you're 6 years old and nearly hysterical with pain and they come atcha with a spinning buzz saw, it is NOT pretty ) and a repeat of the "abuse the kid" process.

I am firmly convinced that orthopedists have the SHITTIEST bedside manner of any medical profession. Every single one I've ever had dealings with (from the jackass when I was 6 who subsequently set bones for every member of the family), to the guy I saw when I sprained my ankle 20 years ago, to the two fellows I saw when I had my first broken elbow, to the guy who put Dweezil's spectacularly (but not funnily) broken humerus back together..... at best, brusque and at worst, deserving of a plaster cast applied at speed to the boy-bits.

I'm just glad (?) that Dweezil's break was bad enough that it had to be handled under full general anesthesia. I'd purely hate to have been jailed for killing an orthopedist for trying to fix it while the poor kid was awake.
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  #16  
Old 02-28-2007, 10:50 PM
Eva Luna Eva Luna is offline
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Quote:
Originally Posted by adam yax
Is that the thing that has little metal shafts poking through the skin? I think I'd rather have a crooked bone than one of those things. Keeping the 'holes' sterile seems like it could be a bit of a challenge. Not to mention the creepy visions running through my mind imagining that getting caught on something.
Yeah, I had one on my left leg for 6 months (it's called an Ilizarov device - here's a picture) in an attempt to get my shattered tibia and fibula to heal together, because the bone fragments were too small to be held in place by a traditional cast, or even an internal plate (I have one of those too, on my fibula). Not a fun experience, in the least, though it probably beat the alternative, which was likely never having the bones heal properly and being crippled for the rest of my life. I had to swab the holes with cotton swabs dipped in betadine twice a day, but still got a number of infections at the pin sites.

(The only bright side of that experience was the jokes. I used to go to my ortho for checkups every couple of weeks or so, upon which he would X-ray my leg and then adjust the fixator with a wrench. My then-boyfriend used to joke that at least I could count on getting screwed regularly by a nice Jewish doctor.)
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