Bone regeneration

[bung bo]

I've got a broken scafoid bone in my wrist and must have surgery to repair it. The procedure would be to take some spongy bone out of my iliac crest and pack the break in my scafoid with a screw in the middle. The doctor said the recovery period is 2-4 months. My question is this:what are the foods and supplements that would promote the compaction and hardening of the bone? I'm already taking a joint soother(glucosamine, MSM, chondroiton) and shark cartilage. Any advice would be greatly appreciated.

[Toby]

Without knowing what I'm talking about, I'd say you've got everything covered. I might add a tonne of milk and some fish oil.

[Serpent]

Screw the milk, unless it's certified unpasteurised. You get more calcium from dark greens in combo with vitamin D (lots of sunshine!) Use a good dit da jow and massage while it heals too, to promote healing more quickly. Also, pay good attention to your rehab exercises. You will lose mobility in the wrist due to the screw, so make sure you make it as reduced as possible.

[IronFist]

What happened?

Get better soon!!

[bung bo]

Thanks for the info guys. I've been rubbing a lot of jow into it to keep any inflammation down. I'll be on my own if there is any PT to go with the recovery since I won't have insurance after the end of the year.

Iron-One of my gongfu brothers who is way stronger than me and I were doing a deng ta drill. ( there is a clip of this drill on Tainan Mantis' quicktime clips thread in the Mantis forum) At the end of each repitition you were supposed to push your partner back. Well, he pushed me hard and I went flying and i landed on my back with my hands hyperextended under me. My right wrist hurt BAD. I got it x-rayed 3 days later and was told it wasn't broken. I trained on it for 5 months and took time off. I went to an orthopaedic surgeon last week and saw the new x-ray. The bone was obviosly broken. So I think it was cracked a little and i knocked the crack open more. I think it's been broken for a few months. I really pulled a Charlie Gordon this time.

[SAAMAG]

I broke my scaphoid bone in my left wrist April , 2002. As I write this my wrist is still not healed. I have had two surgeries, and currently am using a bone stimulator as a last effort to get it to heal.

To be honest, that bone is one of the most common bones to break in people that are athletic in their activities. In addition, it's also one of the hardest and most unpredictable bones to heal. Healing times vary from individual to individual, and a'lot depends on how (angle of fracture) and where the bone was broken (closer to the distal or proximal edge) and how soon thereafter treatment was done. Another determining factor is how much blood flow is available after the break.

That particular bone is surrounded by anticular cartilage almost entirely. It has one entry of blood flow. Often times when a fracture occurs, the bone's blood flow is limited or lost. That is why if surgury is going to be used as the first treatment (as opposed to casting for "x" months) then a vascularized bone graph is usually recommended by many specialists. It sounds to me like you're getting a bone graph from your iliac crest in your hip. They will packing in vascularized bone into the fracture site in efforts to "spark" the bone cells to regenerate after they've destroyed the damaged bone. (all healing starts with the cells destroying and ridding itself of the damaged bone and then regenerating it). Now the other option is to get a vascularized graph from the radius wherein the piece of bone comes from the distal end of the radius, and has an arterial "leash" on it. It is then attached and packed into the fracture site of the scaphoid. In this method not only does the fracture receive vascularized bone, but also a continuous addition of blood flow. (or an only source depending on the severity of the fracture).

Now with all that being said I will share details of my experiences:

My first surgery was within two weeks of the break, (the fracture didnt show up in the first week) and it was a pin and screw fixation with 1 month of immobilization, and then 4 months of a removeable cast. After that it was only the screw. The bone showed signs of ridding itself of the damaged bone, but didnt regenerate any of it. The only good thing from this is I showed no signs of limited movement in the wrist. A year goes by and the doctors finally say that it is a non-union (whereas previously it was classified as a delayed union). I caught wind of another method of healing called a bone stimulator, and did some research on it and asked the doctors about it. A lot of them said it was just the placebo effect healing the bone and it was unknown whether or not the bone would've healing anyway. So that was a no go because of their opinion. The next step in their minds was to do another surgery, but this time a vascularized bone graph. (same as described above). So I got this surgery this year, in early March. As I write this the bone is not healed, however shows some small sign of improvement in the X-rays. Although the break is still visible. In addition this surgery DID inhibit my wrist movement - I lost major dorsal flexion and palmer flexion, as well as ulnar and radial deviation. About 30 days ago, the doctor (a plastic surgeon) finally said to go ahead and try the bone stimulator. It seems that has a positive effect as well because in the time I've been using it, the pain in the wrist feels "different", and in my mind can only be attributed to changes in the bone structure. The pain is less now, and only causes the sharp acute pain when I attempt ulnar or radial deviation. Palmer and dorsal flexion cause pain but not to the same degree.

I know this is long...but I hope it will help you. Remember, doctors are doctors, but they are also people. This is your body. Any decisions recommended by the doc's should be researched and approved by you. You have to feel comfortable. I wanted to use the stimulator before the bone graph, because I just didnt want the surgery but was shut down. Now it comes full circle and they want to do it, and now it shows signs of healing. If they had done it before, I would've retained most of my wrist mobility. So do the research before you give the ok for anything.

I also am using something on it now called Zheng Gu Shui. It translates to "bone setting solution". I can't say whether or not it is having a positive effect as well because I was using the bone stimulator prior to the jow. But it did help the bruises on my shin bones overnight! So take that with a grain of salt.

Take care...good luck. I hope you have a better healing time then me. If you need some more info just email me. I was going to school for radiology and also did a lot of research on this particular bone and it's quirks.

[Shaolinlueb]

I know a guy that had the same thing happen to him. it was non MA related. but the wrist still hasnt healed. be careful and let it heal best before training. cnsult your doctor, they know best.

[SAAMAG]

Actually the current specialist said I could go ahead and start practicing my martial arts again, and even weight train again. Just to let "pain be my guide". Use lighter weights, make no contact on the wrist and be careful not to let anything strike it laterally or from the front (IE no palm strikes or blocks with that arm). Said it would be better just to make no contact whatsoever until it heals. So Im engaging in a little chi sau, and I have to make some contact when Im teaching my students, since the chi sau is light anyway, and the man sau drills are relatively low level, I've been fine so far....only had it smacked a couple times and have had a wrap/brace on it when training up until last week. I don't plan on this ever happening again so I won't jeapordize it.

I just want to make sure Bo's wrist doesnt follow suit. I say get that bone stimulator. It has an 87% healing rate. It is supposed to heal non unions and speed up healing time on fresh fractures.

[bung bo]

Thanks, Vankuen. Ilike it when posts are long. It was very informative and thorough. How long did your doc say your recovery time would be? I want to go back to the acupuncturist when the cast is off to help the blood flow. The break is diagonal from distal to proximal at a 65 degree angle. the doc said my bone alignment was good, and it should heal clean. Best wishings for a speedy recovery, Vankuen.

[SAAMAG]

The doc's said the same thing about mine. The break initially was barely visible and the alignment was good. When the herbert screw was put in, the crack was a little bigger, but alignment was still there so the doc said it should heal within 6 months. Like I said before, the bone is highly unpredictable. My fracture was actually worse (as far as the space between the bone fragments was concerned) as time went by. I contributed this to the elimination of damaged bone, not from the AVN. Now remember that the blood flow comes from a small vessel on the distal side. The more proximal the break the more trouble it will have to heal. It sounds like your break was similar to mine, except that mine may have been a little closer to the middle proximal end.

As far as acupuncture goes, I had it done about the 6 month mark after the break. It didn't help one bit. He actually stuck one of the needles directly into the fracture (by mistake?!) and that hurt like hell. The TCM doctor said it would heal in a couple of months. Whatever.

My advice still stands. No matter how good everything seems initially, have the doctor prescribe the bone stimulator. It's better to be safe then sorry. There can be no negative effects from it so your doctor should have no good excuse not to use it. It would just increase the odds of it healing and the time it takes to heal. The one Im using is called an Exogen 2000 + from Smith and Nephew.

[yu shan]

bung bo

I`m pretty sure you can find this at the farmers market (asian store). If not, I can pick up a bottle on my next trip to Tampa. Be well...

[Hua Lin Laoshi]

You've got plenty of info to help you heal, especially from Vankuen. The bone stimulater is your best high tech solution while the jow is probably your best low tech solution.

I would just add L-Arginine since it stimulates the release of GH in the pituitary. GH promotes growth and healing.

BTW, take it at night for best results.

[bung bo]

Thank you very much for all the good info, dudes. I hate it when I start a thread and nobody ever answers my initial question. I will ask for the bone stimulator while I've still got insurance. I've got a TENS unit my dad got from his doctor when he broke his collar bone. It's called a Transdermal Neural Stimulator. (I've heard both names) Will that help in the recovery?

[SAAMAG]

Hey Bung, the technology of bone stimulators has been changing a lot just as any technology does. The original ones used magnets and electromagnetic fields to stimulate bone formation, the exact methodolgy is too much to write at this time, but it was a 50/50 chance it would work at best. The new ones use ultrasound technology similar to the one they use to take photos of babies still in the womb. These provide about a 87% chance of healing nonunions and healing fractures faster in general. Again, Im using the Zheng gu shui as well for chinese linament. So Im trying to use the best of both worlds.

As of today, I can feel a difference in the wrist since implementing the two prementioned activities. Honestly, it's mostly the stimulator (daily) and occasionally the jow when it hurts or is strained.

Im pretty sure I've caught carpel tunnel on the way along with some good ol arthritis as time goes by...but hey, at least I will be able to punch again soon.

[bung bo]

...but hey, at least I'll be able to punch again soon.

That's great, man. When the doctor told me that this would probably never heal without the surgery, what you said was my main motivation to have it done. The first couple of hours after I had scheduled the surgery I was kind of in shock. I had just gotten a new job and now I had to call them and tell them I coudn't start. And I had to keep working at the mall, and blah blah blah. I thought," This is the only way that I'm going to be able to practice gong fu how I want to." It was all clear after that. The fact that I know what the problem is and that it will be fixed is setting my mind at ease more than it was. (I had been out of class over a month and gotten acupuncture 8 times and it still hurt. I didn't get it.) I hope the recovery isn't too boring.

[yu shan]

For a man who has a broken wrist you did well with two-person crushing step form tonight, not to mention the 7* partnered exercises. I appreciate you seeing thru the pain.

Too bad you cannot find zheng gu shui here, does not surprise me though. I`ll get on the horn and have some sent.

[Serpent]

Originally posted by yu shan
I`ll get on the horn Ooo-er, Missus!

With regard to the scaphoid break - I'd be very careful of just seeing through the pain and training too hard on it. Lots of soft physio to maintain a good ROM and then training when it's healed would be advisable.

[bung bo]

Thanks for the compliment, Shifu. No Zheng Gu Shui here. Dissapointing, but not too suprising. I agree with you on that.

Serpent, the scafoid isn't limiting me that much, if you can believe that. Last night was the first 2-person I did in 2 months. I took it real easy, too. The thing that hurt was my elbows. (see my "nerve pain" thread)