Slow Bone Healing After Fractures: Should You Get Tested?

Is slow healing of a fracture, with little to no bone growth, a reason to get checked?

Hello, Doctor.
I am 30 years old.
Three months ago, I was in a car accident where I fractured the bones in two of my left hand fingers: the little finger and the ring finger.
The doctor inserted two steel pins into each of the fractured bones.
By mid-October, after a long period of recovery, the ring finger and little finger had only healed to about 90%.
The doctor considered that the steel pins needed to be removed; otherwise, I would have difficulty bending my fingers in the future.

From the time of the accident until the beginning of this month, it has been three months.
My little finger has healed, but my ring finger has remained at the 90% recovery stage, and the doctor mentioned that there has been virtually no progress since mid-October.
I do not smoke, and in my daily life, I am exposed to secondhand smoke for no more than two minutes.

My brother had a foot fracture at the age of 31, with the bone cracked to 80%.
The doctor did not use steel pins but opted for immobilization.
For the first four months, my brother's bone showed no signs of healing.
He also does not smoke and dislikes the smell of secondhand smoke.
It wasn't until the fourth month that he began to see bone growth, which continued for three months.
After reaching about 90% recovery, there was no further growth, and this state persisted for two months without him returning for X-rays.

Neither of my parents has had a fracture, so we are unsure if there is a genetic or physiological connection.
Orthopedic doctors have said it is not related, but I would like to know if there are tests that can determine the reasons for the slow bone healing in both my brother and me.
We are both built like wrestlers, have no dietary restrictions, and take calcium citrate supplements, so it is surprising that our bones are healing slowly.

QOO, 30~39 year old female. Ask Date: 2015/11/12

Dr. Liao Yaopan reply Family Medicine

Hello, regarding the issue of bone healing, it is still recommended to consult with a subspecialist (orthopedic surgeon) to assess each patient's condition.
The factors that influence the possibility of achieving full recovery are indeed quite diverse.
Moreover, it is crucial to consider functional recovery rather than solely focusing on structural healing.
Appropriate rehabilitation therapy should also be implemented during the critical healing period.
Thank you for your concern from Changhua Hospital.

Reply Date: 2015/11/12

More Info

It sounds like you are experiencing significant concerns regarding the slow healing of your fractures, particularly in your ring and little fingers. Given your situation, it is essential to understand the factors that can influence bone healing and the potential need for further evaluation.

Bone healing is a complex biological process that can be influenced by various factors, including the type of fracture, the patient's age, overall health, nutritional status, and even genetic predispositions. In your case, you mentioned that your little finger has healed well, while the ring finger has not progressed as expected. This discrepancy can occur due to several reasons, including the location of the fracture, the stability of the fixation, and the blood supply to the area.

The fact that your brother also experienced slow bone healing raises the possibility of a genetic or hereditary component. While there is no specific test to determine if you have a genetic predisposition to slow healing, discussing your family history with your healthcare provider can provide insights into whether further genetic evaluation might be warranted.

In terms of testing, if you are concerned about the healing process, there are several imaging modalities that can be utilized beyond standard X-rays. While X-rays are the most common and cost-effective way to assess bone healing, other options include:
1. MRI (Magnetic Resonance Imaging): This can provide detailed images of both bone and soft tissue, helping to assess the healing process and any potential complications such as non-union or malunion.

2. CT (Computed Tomography) Scans: CT scans can offer a more detailed view of the bone structure and can be particularly useful in complex fractures.

3. Bone Scintigraphy (Bone Scan): This nuclear imaging technique can help identify areas of increased metabolic activity in the bone, which may indicate healing or infection.

4. Ultrasound: While not commonly used for assessing bone healing, ultrasound can sometimes provide information about soft tissue and blood flow around the fracture site.

If your healthcare provider suspects that there may be an underlying issue affecting your bone healing, they may recommend blood tests to check for conditions such as vitamin D deficiency, calcium levels, or other metabolic bone diseases.

In addition to imaging and laboratory tests, it is crucial to ensure that you are following a proper rehabilitation program. Physical therapy can play a significant role in promoting healing and restoring function. Engaging in appropriate exercises can improve blood flow to the area, which is vital for bone healing.

Lastly, if you have concerns about your healing process, it is essential to communicate openly with your orthopedic surgeon. They can provide personalized advice based on your specific situation and may suggest further evaluations or interventions if necessary.

In summary, while slow bone healing can be frustrating, there are various avenues to explore for understanding and potentially improving your situation. Engaging with your healthcare provider about your concerns, family history, and the possibility of further testing will be key in addressing your slow healing and ensuring the best possible outcome for your recovery.

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