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View Full Version : How long do adults wear cast for broken bone?


Mike Onghena
01-10-2010, 08:34 AM
Fractured arm (4" above wrist) in karate accident. (Blocked a kick I should have taken or sidestepped). ER xray showed fracture, no displacement of bone, just cracked. They put a temp cast on, but I will see ortho in a few days for real cast.

I'm 42, & haven't been in a cast since about 15. Am I looking at 6 weeks? Or is it longer due to my age? I forgot to ask ER doc..

Thanks

Wayne Riddle
01-10-2010, 09:26 AM
My guess is that there will be many factors that determine how long you have to wear a cast. Could be a couple of weeks, could be several. Your doctor would be the best person to give you a good idea.

Steven Low
01-10-2010, 09:34 AM
Depends how fast it heals.

Take vitamin D (10,000 IU per day) and calcium supplements (at least 1,000 mg calcium per day if not bit more).

You'll heal very quickly.

Everett Steinbarger
01-11-2010, 12:46 PM
The broken bone will take 6-8 weeks to heal.

If you are treated in a cast it will be on for about 6-8 weeks. With the fracture 4" proximal to the wrist, you are lucky if there is no displacement or angulation.

I've read some of the research on Vit D supplementation, Calcium supplementation, and a lot of other stuff that has gone by the wayside in the last 20 years in regards to faster healing of bones. To date, Vit D is the only bright spot on the horizon, but even the data on that is lacking at this time.

Some of our elderly patients have been prescribed high dose Vit D by their family doc while we treated the fracture. In those few patients I saw no difference in healing times. One of the ankles that comes to mind took a significantly longer time than usual to demonstrate radiographic bone callus. I kept that patient non weightbear for nearly 8 weeks, and immobilised for 12.

Just my 2 cents. (FYI, I personally take high dose Vit D myself. I do believe that down the road we will appreciate it's effects more fully, but at this time I there is no concrete data to say that it will reduce the healing time of a fracture.)

Steven Low
01-11-2010, 07:53 PM
Everett,

With higher dose vitamin D it can actually leech calcium and all of the minerals that make up hydroxyapatite and the other connections within the bone matrix.

If you go higher dose vitamin D what I've been finding is that you DEFINITELY need the raw materials to see any appreciable results. Calcium especially but you probably need high amounts of magnsium and phosphates as well.

My personal experience is that on higher dose vitamin D I can tell when I haven't taken it because it will irritate by previously irritated osgood schlatter's by removing bone matrix. If it gets sore I can tell that I haven't had enough calcium/magnesium.

I now just take normal dose ca/mg/zn but it's probably better to take more than normal especially if going up to 5-10k IUs.


Basically, I am pretty sure if supplemented 150-200% daily values for ca/mg (100% DV for ca = 1,000mg and mg = 400mg... so do the math I guess) + 10k IU vitamin D that you would see faster healing rates.

I think there may be some other data for which minerals are required for osteoblast activity so I may have to recheck that.

Everett Steinbarger
01-12-2010, 02:59 AM
Steven, I agree with everything you have said and I have no doubt that in the future, research will bear out a faster healing rate in regards to VIt D supplementation. I am not sure that it will be any faster for the patient though. The cut in time for a fracture to heal may not be percebtible to most. Most people aren't going to understand the medical community being thrilled with cutting time to heal by a few days while the time they were casted was 5 weeks and 3 days.

There are few things on the horizon that I watch with anticipation. Decreased fracture healing time is one of them. Cartilage regeneration is another. Whoever masters those 2 problems will be a rich man/woman.

Before the osteoblast activity starts at a fracture, osteoclast cells have already arrived and are tearing down the building blocks at the site of injury. The raw material is already there to rebuild the fracture. Even patients who are terribly osteoporotic and elderly, heal their fractures in the 6-8 week time frame.

Mike (OP): I just thought, if you were performing a lowblock or a sideblock you may have fractured the ulna. If it is the ulna and the radius is OK, you may not have to be casted at all. A splint for a few weeks may be all that you have to put up with. Your surgeon may also elect to have you out of your cast a few weeks before the fracture is fully healed if your pain is under control.

Mike Onghena
01-13-2010, 07:04 PM
Thanks for the replies..



Mike (OP): I just thought, if you were performing a lowblock or a sideblock you may have fractured the ulna. If it is the ulna and the radius is OK, you may not have to be casted at all. A splint for a few weeks may be all that you have to put up with. Your surgeon may also elect to have you out of your cast a few weeks before the fracture is fully healed if your pain is under control.

I fractured the bone on the pinky side of the forearm. I saw ortho on Monday and I'm in a cast now which will come off in 4 weeks and another xray taken at that time to see how it looks. I am grateful for the cast as it still hurts. Doc called it a 'nightstick' fracture, as if I was hit with a nightstick. xray showed some cracks and a small wedge of bone which looked like it broke off, but the inner side of the bone was nice and straight with no bend..

I am taking extra vitamins, but not 10k of D, I couldn't find anywhere close to that dose. I take about 1800 D, 1500 calcium 2x a day, plus whatever else is in the multivitamin. I also drink about 2-3 Gallon milk per week or more.

Everett Steinbarger
01-14-2010, 06:30 AM
Night stick fractures aren't all that common. You lucked out to be sure. Some people treat nightsticks with no cast, but I find that most people are more comfortable in a cast. You may not be completely healed at 4 weeks, but the fracture should be stable and pain free enough to shed the cast.

If the fracture had displaced, proper treatment would have included surgery to realign the ulna. Then you would have been casted as well.

Take your Vit D. Steven has good info on how much to take. I've been using it for a week at 10,000 a day for a tendon that has been painful for a year. These last 2 days are the 1st pain free days I've had in a long time.

Mike Onghena
01-14-2010, 07:22 AM
Take your Vit D. Steven has good info on how much to take. I've been using it for a week at 10,000 a day for a tendon that has been painful for a year. These last 2 days are the 1st pain free days I've had in a long time.
I'll add some more to what I am taking.

Steven Low
01-14-2010, 05:46 PM
I'll add some more to what I am taking.
After you run out you should get the 5,000 IU or 10,000 IU soft gels.

Much cheaper.

Mike Onghena
02-11-2010, 06:11 PM
In case anyone was following this, I got my cast off yesterday, 4 weeks and 4 days after fracturing arm. Doc said that bone is still damaged and healing well, but well enough along that I don't need the cast anymore. Xray showed bone was straight, but the injury was still clearly visible. 4 more weeks until I can go all out with it. Big bump over fracture which is normal.

It still hurts, so I have no plans to do anything strenuous with it for some time still. Primary focus this week is to get range of motion back to my wrist. Although it was not injured, being locked in the cast for 4 weeks has really done a number on it.

I also measured my injured arm (upper), and found it to be almost 1.5" smaller in circumference than the other one. So I have lots of work to do once it is fully healed. As it was my non-primary arm, it probably started out a bit smaller.

I did 10000 or so iu of vitamin d daily, along with extra calcium and my usual few gallons of milk per week. No idea if it helped, but it didn't hurt.

Everett Steinbarger
02-12-2010, 02:49 AM
Hey Mike.

Good to hear that things are moving along smoothly for you. Take it easy out of that cast, it's icy outside.

If you wouldn't mind chiming in when you are fully healed and pain free in a few weeks, I'll bet some people would find it beneficial.

......Everett

Mike Onghena
02-28-2010, 07:30 PM
Cast has been off for 2.5 weeks, arm initially fractured 7 weeks ago.

The injury is very sore when I move my wrist, especially when I rotate my wrist like opening a doorknob. There is still a bump where the bone fractured. I think my pain is from muscle and tendon right at the site of injury. At least that is how it feels. Nothing feels damaged, just really really sore. Icing has helped.

I do have a good majority of ROM back in wrist, but it is not fully there yet.
Wrist still hurts and feels bad at extreme angles. I think it will take working with heavy weight to fix it, I've had this type of wrist pain in the past. This is all from being immobilized for 4 weeks, wrist was not injured initially.

I was able to row at pre-injury level after a week or so. I started with the damper at 1 (C2), now it is back to my usual setting of 5. My 500 time is about the same as it ever was.

It took about 2 weeks before I could do a pushup, I can now do 20 painful ones.

I am doing squat, deadlift, press and bench at about 1/2 - 2/3 PR levels. I had a few months off before injury, so I'd be down from PR levels anyway.

I tried to clean today, but cannot get the bar up to rack position yet. I also considered doing a dip (bar) and was able to hold the top position, but I was not able to lower myself. I can do a few jumping pullups, but not very good ones. I think that is the next thing to work on.

After 2 weeks with the cast off, I went from feeling injured to just feeling sore. This helped me get started with weights again. I still won't hit anything, like a punching bag, or the floor with burpees etc. No plans for wallball for the time being etc. But I can ease into slow lifts.

Steven Low
03-01-2010, 07:25 AM
Keep up mobility work --- take it to as far as you can without pain as often as possible.

Gets the muscle moving bringin blood flow for healing + tells your body that your mobility is getting better without pain

Mike Onghena
03-12-2010, 03:43 PM
Final visit to doc 2 days ago. It still hurts, but the pain is getting better. Actually, the pain is about the same, but I can do more with the same levels of pain. One last xray showed bone healed well (according to doc, still looked mangled to me).

Doc said I can do anything I want except take direct impact to it. He expects the pain to be gone in 6 weeks.

Mike Onghena
06-10-2010, 06:18 PM
Last update for the benefit of anyone who is in a similar situation and wants an idea of recovery timeframe.

It's been 5 months since I fractured the arm, and I am basically pain free. No worse than a minor soreness when doing certain things. There is still a bump on the arm which might be there forever for all I know.

The good news is that I've been at full strength and capability for weeks. I set PRs in Bench, Deadlift, Squat, Dips during month 4. I am at my previous best in pullups and press. I've also taken some more hits to the area in karate already :(.

So, I'd call it 100% better by 4-5 months max. Probably a bit earlier as it took some time to work back to my previous levels. I had taken a few months off before the injury for other issues.