the Risks and Recovery of Left Humerus Fracture Surgery

Q: the Risks and Recovery of Left Humerus Fracture Surgery

Hello： Since I am unable to see your recovery status and X-ray images, I cannot assess your healing condition. <br>I recommend that you visit another hospital for a physician to evaluate and provide you with advice. <br>Thank you.

Old injury: comminuted fracture of the left humeral joint?

Hello Doctor, I have been experiencing physical discomfort due to work and am considering surgery.
About eight years ago, I suffered a comminuted fracture of the left humeral joint in a car accident.
I underwent surgery at the National Defense Medical Center (NDMC) and the wound has healed.
Approximately seven years ago, I had a procedure to remove the steel wire (two steel pins and wire from the inner side of my arm).
At that time, I wanted to remove the plate along with more than ten screws and the wire, but the doctors there said there was a shortage of staff and that the surgery carried risks, so they opted for the procedure I had instead.

After graduating from university, I faced military service issues, and the physical examination results showed I was in normal condition.
My arm can bend to 170 degrees, but I am unable to do push-ups (I have grip strength but lack pushing strength).
The examining physician suggested that this was a minor surgery and recommended I undergo it during my military service.
However, circumstances changed, and I served in an alternative service instead, so I did not have the surgery.

Over the years, due to family financial constraints, I was unable to have the surgery.
After completing my military service and entering the workforce, I feel it is time to address my physical issues.
My company has asked me to assess the risks and potential recovery outcomes post-surgery.
I have consulted several doctors who reviewed my X-rays and indicated that it is likely a minor surgery, but the post-operative recovery status is uncertain.
My company has advised against the surgery, suggesting that there is a possibility I could lose function in my left hand, and they want me to continue working.
I have been with the company for a year and a half, during which I experienced a work-related injury that resulted in my left index finger being partially amputated.
I understand that all surgeries carry risks, and I would like to know the likelihood of my recovery.
If I do not proceed with surgery, I believe I may need to consider changing jobs.

NNNN, 20~29 year old female. Ask Date: 2015/09/05

Dr. Xie Hongjia reply Orthopedics

Hello: Since I am unable to see your recovery status and X-ray images, I cannot assess your healing condition.
I recommend that you visit another hospital for a physician to evaluate and provide you with advice.
Thank you.

Reply Date: 2015/09/05

More Info

When considering surgery for a left humerus fracture, particularly one that has been previously treated and has left you with functional limitations, it is essential to weigh the risks and potential benefits carefully. Given your history of a comminuted fracture and subsequent hardware removal, it is understandable that you are concerned about the implications of another surgical intervention.

Risks of Surgery
1. Surgical Risks: Any surgical procedure carries inherent risks, including infection, bleeding, nerve damage, and complications related to anesthesia. In your case, the presence of previous hardware and the complexity of the fracture may increase these risks. Surgeons often assess the risk-to-benefit ratio before proceeding with surgery, especially in cases where previous surgeries have been performed.

2. Functional Outcomes: While many surgeons may classify your situation as a "minor surgery," the functional outcomes can vary significantly. Factors such as the extent of the original injury, the quality of bone healing, and your overall health will influence recovery. There is a possibility that surgery could improve your range of motion and strength, but there is also a risk that it may not yield the desired results, or worse, could lead to further complications.

3. Psychological Impact: The fear of potential loss of function or worsening of your condition can be daunting. It is crucial to address these concerns with your healthcare provider, as they can provide insights based on your specific case and help manage your expectations.

Recovery and Rehabilitation
1. Healing Time: Generally, the healing time for humeral fractures can range from 6 weeks to several months, depending on the severity of the fracture and the surgical technique used. After surgery, you may need to undergo physical therapy to regain strength and mobility. This rehabilitation phase can last anywhere from a few weeks to several months.

2. Physical Therapy: Engaging in a structured rehabilitation program is vital for optimizing recovery. Physical therapists can help you regain strength, improve range of motion, and reduce pain. They will tailor exercises to your specific needs, which can significantly enhance your recovery experience.

3. Long-term Outcomes: Many patients experience significant improvements in function after surgery, but this is not guaranteed. Some may still face limitations in strength or range of motion, particularly if the injury was severe. It is essential to have realistic expectations and to discuss these with your surgeon.

Decision-Making
Given your situation, it is crucial to have a thorough discussion with your orthopedic surgeon about the potential benefits of surgery versus the risks involved. You should consider the following:
- Second Opinions: If you have doubts about the recommendations you have received, seeking a second opinion from another orthopedic specialist may provide additional insights and help you make a more informed decision.

- Functional Goals: Clearly define what you hope to achieve through surgery. If your goal is to improve your ability to perform daily tasks or return to a specific job, communicate this with your surgeon. They can help you understand whether surgery is likely to help you meet these goals.

- Alternative Options: If surgery is deemed too risky or unlikely to provide significant benefits, explore non-surgical options such as physical therapy, pain management strategies, or adaptive techniques that may allow you to continue working without surgery.

In conclusion, while surgery may offer a chance to improve your condition, it is essential to weigh the risks against the potential benefits carefully. Engaging in open communication with your healthcare providers, seeking second opinions, and considering your long-term goals will help you make the best decision for your health and well-being.

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