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Old 01-10-2010, 08:34 AM   #1
Mike Onghena
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How long do adults wear cast for broken bone?

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..

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Old 01-10-2010, 09:26 AM   #2
Wayne Riddle
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Re: How long do adults wear cast for broken bone?

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.
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Old 01-10-2010, 09:34 AM   #3
Steven Low
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Re: How long do adults wear cast for broken bone?

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.
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Old 01-11-2010, 12:46 PM   #4
Everett Steinbarger
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Re: How long do adults wear cast for broken bone?

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.)
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Old 01-11-2010, 07:53 PM   #5
Steven Low
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Re: How long do adults wear cast for broken bone?

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.
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Last edited by Steven Low : 01-11-2010 at 07:56 PM.
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Old 01-12-2010, 02:59 AM   #6
Everett Steinbarger
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Re: How long do adults wear cast for broken bone?

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.
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Old 01-13-2010, 07:04 PM   #7
Mike Onghena
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Re: How long do adults wear cast for broken bone?

Thanks for the replies..

Quote:
Originally Posted by Everett Steinbarger View Post

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.
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Old 01-14-2010, 06:30 AM   #8
Everett Steinbarger
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Re: How long do adults wear cast for broken bone?

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.
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Old 01-14-2010, 07:22 AM   #9
Mike Onghena
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Re: How long do adults wear cast for broken bone?

Quote:
Originally Posted by Everett Steinbarger View Post

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.
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Old 01-14-2010, 05:46 PM   #10
Steven Low
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Re: How long do adults wear cast for broken bone?

Quote:
Originally Posted by Mike Onghena View Post
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.
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