Work Stuff

Fractured

Sorry about the graphic parts of the above video, but this is what happens when there’s trauma – it’s messy, gross and painful.

Our doctors actually see a lot of spinal/skull fractures. We would never see an open fracture because if someone presents to the ER with an open spinal fracture, they are likely paralyzed. If they present to the ER with an open skull fracture, they will likely require brain surgery stat.

The fractures we see in the clinic are people who had an accident, fell off something, or were involved in an MVA, (motor vehicle accident), or someone simply tripped over something and fell flat on his/her face.

There’s not much you can do when you fracture your spine – both surgically and literally. When you fracture your spine, you have technically broken your back but not severe enough for paralysis. Most of the time, it’s a hairline fracture and you will be required to wear a brace, sometimes for several months, to allow your bone to grow back. If you do not wear this brace, and you make the fracture worse, then you CAN possibly make that fracture worse and crack it in two.

Then you’re really in trouble.

No one likes wearing the brace. In fact, if the fracture is severe enough, our doctors will sometimes offer surgery in order to go in, brace the spine with rods to hold it in place, and then they come back and have the rods removed once the fracture heals. They don’t do this very often – I’m sure the circumstances has to be just right, but for some people, it’s preferable to wearing a very restrictive brace for weeks/months.

I’ve found that people are on the extreme ends of the spectrum when it comes to fractures. On one end, you have the people that are completely freaked out and are convinced one wrong move will render them paralyzed. And yes, sometimes fractures are that severe and you have to be very careful, but often times, it’s not as bad as one might think. These people are afraid of everything and are very tense.

Then you have people that are supposed to wear a brace and don’t. Those are the ones who aren’t taking the fracture serious enough and don’t seem to realize – a brace is there to prevent you from making the fracture worse. And again, if the fracture gets worse, you’re really in deep doo-doo.

If you have a cervical (neck) fracture severe enough, or close enough to your brain stem, you may have to wear a halo.

The ring is attached by four bars to a stiff, lightweight vest that fits around your chest. This keeps your neck and spine moving as one with your body so the spinal injury can heal. Most people wear a halo for 6 to 12 weeks. You can expect your neck and back to feel stiff or sore at first.

I had to assist a PA in removing one of these bad boys one day. When you wear a halo,  you have to wear it for weeks, and you can’t wash your hair, and it’s very hard to bathe at all. So when patients come in to have their halos removed, they stink.

BAD.

And their hair is greasy and stinky. It was enough to almost make me gag.

The halo part that goes around the skull is literally screwed into the skull on all four sides. I used what looked like a small crescent wrench and loosened the screws. I loosened all of them a little at a time until we could finally slip it off the patient. The patient will have holes in his scalp which will scab over and eventually heal and fall off. So they must be careful when he/she can finally wash his/her hair.

Removing the halo was both gross and fascinating and I’m glad we don’t have to do those very often. But I’m glad the PA gave me the opportunity to remove it, at least once.

Patients with fractures don’t normally require surgery but they must be monitored. We usually see fracture patients back about 4-6 weeks after the injury with an xray prior to see how the fracture is healing. If it’s slow to heal, because the bones are weak, or the patient hasn’t been wearing his/her brace, then the doctor will have them come back in another 4-6 weeks with another xray until he/she is finally released from the brace and the fracture has healed enough not to cause damage.

I thought the part in the video above, how the calcified bone surrounds the injury and makes new bone was interesting. I didn’t know that part, Isn’t it fascinating how our bodies heal themselves?

It’s funny how we evolved like that, huh. (Inside joke between me and Kevin – every time something fascinating happens with the body, Kevin likes to snicker and make fun of evolution – which we obviously don’t believe in).

Fractures are painful an there is little you can do for them other than suffer through them until they heal. I always feel sorry that come in with fractures as we don’t do anything other than monitor how they are healing. Our doctors don’t prescribe pain medication  unless patients have had surgery so we get a lot of upset patients when they come in to see us.

You can’t really avoid fractures, enough stress and your bone will simply snap, but you can keep your bones strong so that they are less likely to snap. A lot of times, if fractures take a long time to heal it’s because the patient smokes (which SEVERELY limits healing of any sort), or the bones density is poor and the bones themselves are brittle.

I’ve started taking calcium, magnesium, zinc and vitamin D every day now. I mentioned in another post how my body was simply aching whenever I went to bed and I’ve noticed it doesn’t seem to be aching as much since I’ve started supplementing my diet.

So seriously, if you’re getting older, pay attention to your calicum/vitamin D intake. You could save yourself from a broken hip later in life.