On 7/20 this year I had foot surgery which I’d been putting off for years. Silly me for doing that. My issues ultimately were more serious and the healing much slower than anybody, my surgeon included, would’ve realized.
The upshot is that I’m still not back at work. My recovery has been difficult, mostly because I have what’s referred to as “non-union healing”, meaning that my fractures aren’t knitting together the way they’re supposed to. Nobody knows why this is. My labs were all normal and I’m not lacking in anything.
Ergo, a bone stimulator. I’d never heard of one before. Apparently there’s a theory that ultrasound works just as well on healing fractures as it does in easing muscle pain. It’s a contraption that you attach to the area in question for X times a day for Y time. I was told I’ll probably be on bed rest given my issue.
I get it on Halloween and I’m to use it through Thanksgiving. Then I go back to the surgeon for an x-ray to see if it worked.
Has anybody ever used one? What was your experience?
I had one for a femur fracture that wouldn’t heal. At the time, I was totally none weight bearing. I had a small amount of progress but it continued to be a non-union until I was able to start bearing weight.
I have no idea if the stimulator had any effect during the non weight-bearing phase.
This was 14 years ago so it’s possible they’ve improved.
I have been using the Exogen model on my olecranon for a month. Surgeons at the Hospital for Special Surgery in NY (one of the best ortho hospitals in the world) recommended it, and I found that there is decent research evidence supporting it for some types of non-union - borne out by the fact that my not-great insurance approved the $3k cost without hesitation. Revision surgery is not fun, and much more expensive of course.
It’s simple to use, only 20 minutes a day, which is important because I have a lot of other PT exercises that I need to dedicate time to, and there just isn’t time for everything. There are magnetic field devices with similar evidence of efficacy, but the protocols require hours each day.
I don’t think anecdotal stories about whether it worked are of any value, you should check out the research data for that.
I don’t have any hard evidence, but many veterinarians seem to have the idea that a cat’s purr is the right frequency to help promote healing. So maybe there’s something to the idea.
I don’t have any information about bone stimulators, I just popped in to say, I’m thinking of you and really hope things start moving in the right direction. I’ve had surgery on both feet, nonweight bearing for 8 weeks both times. I have rheumatoid arthritis and my surgeon told me that put me at a higher risk for the bones not fusing together. I was lucky both times. I’ve heard of the stimulators and I don’t think they can do any harm and if the surgeon thinks it may be a good idea, I’d give it a try.
The weird thing with me is that out of the three surgically fractures I’ve had, two healed just fine. It’s just this particular one which refuses to budge
I am very blessed and lucky that I’ve already surpassed my deductible for this year, so it’s not costing me anything.
I’ve read similar supporting evidence too. Unfortunately my type of non-union tends to be a crapshoot. If it doesn’t work I’m looking at a bone graft :eek:
I’ve got a bunch of PT exercises to do too, so I’m presuming that I’ll be doing those when I’m not wearing it. I’ve already been told it’ll be more than once a day for at least an hour, given my particulars. I’m currently putting a bunch of books on hold at our library, LOL.
I don’t have RA but I’ve got pretty good OA in both feet, which I think is complicating matters. My surgeon keeps insisting that the OA has nothing to do with it.
I was non weight bearing for 6 weeks. The deliberately put me in a knee-length boot so I wouldn’t be tempted to thump around. Crutches and I don’t get along, so there were a number of times where I either stumbled or landed on the foot, especially in the bathroom. I had the same issue with the ankle boot.
The irony is that out of the three surgical fractures I had, two of them healed fine. Nobody knows why this one is being particularly prickly.
I don’t know if there is still time to choose which device you get, but if possible see if your insurance will cover the Exogen device. I looked pretty carefully through the research evidence, and there seemed to be no significant difference between the efficacy of devices from different companies – except for the important fact that the Exogen protocol takes up much less time. You really can’t do any PT with the device on. There is some evidence in favor of these devices, but it’s not so compelling that I think it’s worth sacrificing hours a day when you could be doing other valuable PT work. You maybe using it for many months.
If it doesn’t heal, bone graft is usually the next step. It’s not so much the bone graft per se that’s scary, it’s a straightforward procedure to take bone from your iliac crest. The problem is (for me, at least) that there’s complicated hardware holding together multiple fragments of ulna that must be completely dismantled and then put back together if I need revision surgery.
That’s why I did 8 weeks instead of six in the knee length cast both times. Keep us posted how you make out. I saw another post about your deductible so I’m guessing your insurance will cover it which is good.
Many years ago (at least 30, I would guess) Quirks and Quarks had a segment about a woman who had been on crutches for 13 years because a broken bone in a leg just wasn’t knitting. They tried some kind of stimulator and she healed. But IIRC the stimulation was electrical, not ultrasound.
It’s been almost a week since I got the stimulator (it’s an Exogen, Riemann). Twice a day, 20 non weight-bearing minutes at a time. There’s a Fitbit-like velcro strap with a plastic-coated opening I put around my foot. The opening can be either on top or on the bottom as long as it’s in the area of the fracture. The ultrasound contraption is connected to the handheld controller. You put a dab of ultrasound gel (included with the kit) on the flat surface of the ultrasound. That goes into the plastic coated opening. You then click shut the cover, start the controller, and let 'er do its thing while you read, watch TV, pet the dog, etc.
They say that there are no side effects to this, but I wonder if that depends on how things were before you started? I’m finding that the area where the fracture is appears more bruised the more I use the stimulator. I was told that this could happen as the ultrasound also stimulates blood flow into the tissues. My foot is a bit sore as a result, especially when I’m standing/walking. The swelling also hasn’t gone down. That’s not a good sign, but it’s still too early to tell.
Hey, kiz, what has the podiatrist said about the bruising? I hope you get some positive results, but that doesn’t sound right to me. Then again, as I mentioned before, I have no experience using them.
Waiting to hear back. Considering it took the office almost a week to get back to me re the placement, I’m not holding my breath. However, in my Google travels, I’ve discovered that “bone bruising” is fairly common with stimulators. I don’t know if this is what I’m experiencing, though.
Thought maybe some people are curious about updates.
My bone is starting to fuse together but it’s very slow going, even with the stimulator. I’m still using it. The good thing is that I don’t need a graft :whew:
I don’t remember the exact number, but a stimulator arrives with finite number of treatments, and it’s usually more than what your surgeon prescribes just in case you need to use it more like me. Once you reach that number, the handheld shuts off forever and you must dispose of it – it’s considered medical waste.
The bruising I spoke of earlier is a combination of long-term bruising from the surgery plus minor bruising from the stimulator. Somebody said upthread that the bruising is the result from the blood being stimulated in a precise area. Both will eventually go away.
I graduate from PT in a couple of weeks. The hope is that I can return to work before the end of the month, at least for a few hours per day. My restrictions are going to be numerous, however, so we’ll see if everything pans out.
I had one 20+ years ago, so I can’t remember the details. But my bones didn’t start knitting together at all until I started using it. Even with it, the bones took forever to heal. But I figured it beat the hell out of bone grafting surgery.
In hindsight, I wish my surgeon had explained better about bone grafting surgery, and I will never know whether that would have led to quicker or better healing. But at the time I broke my leg, I was a month into a new job, and I really don’t think I would have been able to keep my job if I’d had to go in for another round of surgery.
Someday I hope to live in a society where people can concern themselves more with long-term healing than with whether they are going to keep their crappy admin job if they are not independently wealthy and have a serious medical issue. Alas, that day has not yet arrived.
I was told that the graft would be taken from my hip. As my surgeon said, “I don’t wish it on anybody – if you think your recovery from this has been tough, quadruple that with a graft.”
I have been extraordinarily lucky and blessed that my employer has kept me on the payroll past my FMLA. I have until the end of January to return. Otherwise they will let me go.
That’s great news you don’t need a graft. Has the stimulator helped speed things up at all or does it not seem to be making a difference? I really hope it’s moving things along for you.
I figured some people were curious about an update on the update.
Had a second opinion which led to a CT scan. CT scan showed that nothing has knitted together. Surgeon is still pushing “no graft” so I now use the stim twice daily and must wear my surgical boot as much as possible.
My husband found a great brand of compression socks on Amazon. I think they’re called Stamina? They’re made for runners but they give excellent support.
Another theory: I have a new Endo Doc who recommended a bone density test because of my age and the fact that I’ve been on thyroid meds for many years. There are some studies out there which show such meds can lead to bone loss. I also had a rather serious bout of hypocalcemia right after that surgery and they’re thinking that also wreaked havoc on my system.