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manmountain8
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05/05/2018 06:18PM   (Thread Older Than 3 Years)
My last post was answered by an ortho surgeon. If you're still out there I could use some advice. My distal radius fracture turned out to be intra-articular (broken into the surface of the wrist joint or the end of the bone. ) Apparently the ER doc did not know how to read the x-ray. The fracture also extends like an extra-articular break across the bone, and then that 2nd fragment has a fracture in it as well. From my research it is a "Smith's Fracture" that is ventrilly displaced. Obviously the closed reduction was unsuccesful. It just looks like a blob of bone. I can see no cup where the wrist joint should be.

Surgery is scheduled for monday to install a plate and the surgeon said I'd be fine to go on my trip on Friday. He says I will feel much better a few days after the surgery and that I will be able to use my hand by the time we leave. Is this true? Is he just telling me what I want to hear?

Could this be reduced arthroscopically or something similar, and held in place with pins and an external system? I don't like the looks of this giant plate their putting in. I have a plate in my hand so I know how that went. It turns out the plate that was installed for a boxers break in 2004, hadn't been used since the 70's. Should I expect this one to go better? They say this surgeon is one of the best.
 
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manmountain8
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05/05/2018 07:01PM  
I bought this Strike Fighter fishing harness for one armed fishing. To set the hook you just lift your leg.

http://sheltonproducts.com/strikefighter.html
 
PatrickE
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05/06/2018 03:36PM  
Few thoughts. Plate and screw fixation is pretty standard for what you describe. There's a bunch of different companies that make this type of plate, some subtle differences between designs, but overall outcomes are very good. Arthroscopically assisted (not many surgeons go this route in my experience, usually not necessary)/CRPP (closed reduction percutaneous pinning)/external fixators are different methods we use for some fractures, but if it were my wrist, I would want the plate and screws for the fracture you describe. There's an advantage not to have metal pins sticking out of your skin for 6 weeks. First off, your surgeon will be staring at the displaced pieces of bone and be able to put them where they belong and hold them there. Remember what we are trying to prevent down the road with fractures that extend into the joint is post traumatic arthritis (think pain, stiffness, weakness). You don't want a weak/painful wrist in 5-10 years. The chance of you losing the reduction after plate fixation is going to be much lower than the cast (I don't usually see it happen unless someone has an additional fall, trauma, or their bone quality is really poor). In my experience, very few number of patients elect to have these plates removed. They are buried under muscle and tendons, you usually can't feel the plate (if done correctly), and generally they don't cause much in the way of symptoms long term. However some patients down the road do elect to have them taken out (9-12 months minimum for me after initial surgery) which is just another trip to the operating room unfortunately, but rehab/recovery is much quicker than the original surgery. One of the other advantages to the plate is that usually your rehab can be accelerated (i.e. try to get back wrist range of motion much quicker than had you had that cast immobilizing the wrist for 2-3 months). Long story short, if your doc recommends plate and screws, I'd go in that direction. Getting another opinion looking for another method of fixing the fracture usually doesn't go so well in my opinion. If you were in my clinic with the fracture you described, a plate it is.

Now to the tougher question...how are you going to feel 4 days after a surgery like this. Everyone's pain tolerance is going to be so varied that I can't really answer this question very well. The vast majority of my patients are still trying to be able to get their fingers into a tight fist at 1 week after surgery. Some are able to do that 2 days after surgery, some 2 weeks. Usually patients aren't able to grasp anything with any force. One concern is taking a fresh incision into the wilderness and risking infection. To be honest, if the bandage is kept covered and clean, your risk of infection is pretty low in my opinion (this may be why your surgeon is okay with you going). If you're getting that bandage/splint/cast wet, well obviously not such a good thing. At 4 days, my best guess would be that you can do some pinching and very light grasping with the hand, but little more than that. Keeping the hand elevated and getting those fingers moving helps a lot to get things moving in the right direction. Pain is the wild card in this situation. I've had patients get by with no pain meds and others asking for a refill 2 weeks after the surgery. Don't mix that brandy with narcotics (or any other liquor for that matter). You may not be very comfortable in a tent and wish you had stayed in your bed at home if you're really hurting once you get out there.

I usually want to see a surgical patient back at around the 7-10 day mark after surgery to make sure the incision looks good and see how they are progressing with the pain/motion. Make sure you are arranging appropriate follow up with your surgeon. To summarize, if your doc feels okay with you going, I'd say make it a game time decision and see how you feel. You may be able to tough it out, but it may not make for a very fun trip. Make sure you let him know how long you're planning on going and how the conditions can be (possibility of getting the post op dressing wet, average activity, etc). Be honest with him so he knows you're not pond fishing down the street from your house for 2 days. Ask him before the surgery....you likely won't remember much after. I've had a few surgeries myself, one was plate and screws for the shoulder. If someone had handed me a fishing pole 4 days after my surgery, I'd have laughed. Definitely wouldn't have felt up for it. The timing is really tough because I anticipate you're going to be feeling much better several weeks out from surgery.

Last personal bit of advice, everyone on this site and their brother is going to have an opinion as to what you should do. It's noboby's body part but your own. Talk to your doc and make an informed decision. Best of luck. It sounds like you're in good hands.
 
mastertangler
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05/07/2018 06:33AM  
One thing is for sure..........if you go we all want to know how it went, for better or worse. Sort of like a reality show. ("and then the big fish ripped the rod from my injured hand and it dropped overboard" etc. etc. )
 
thlipsis29
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05/07/2018 06:56AM  
I am with masterangler. I hope you have a great time, your friends are more than willing to pick up any slack, you don't have any setbacks and you catch the monster pike you're looking for. Please write a trip report when you get back, that is if you can type :^) Wishing you the best.
 
05/07/2018 11:03AM  
mastertangler: "One thing is for sure..........if you go we all want to know how it went, for better or worse. Sort of like a reality show. ("and then the big fish ripped the rod from my injured hand and it dropped overboard" etc. etc. ) "


I haven't read this too closely, but I think I'd be waiting till a later date. Anyway, have a great time and for sure report back on your success!
 
manmountain8
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05/08/2018 03:43AM  
Thanks for the advice. It's done and my arm is still hanging here like a dead piece of meat. Not looking forward to this block wearing off. I did continue to research it and it was clear I had to have the surgery. Fragmented wrist joint is not even grey area. He even had to add an extra screw for the extra fracture that stretched into the joint. There was no way that mess of fragments was going heal right with closed reduction. The surgeon tried to help a woman scheduled just before me. She had a similar less complex break but she was 6 months in before surgery, and had lost the use of her wrist, hand, and fingers. Her surgery was also so complex it pushed mine back by 90 minutes, and the outcome is not going to be nearly as good as mine, so they say. So I think I did the right thing.

We'll see how the pain goes. I do have the harness for one armed fishing. Packsack is pushing our boats. I bought a drypro cast protector that vacuum seals around the cast and even allows you to swim under water. My dad is going to set up our camp and do the filleting and cooking. I need to figure out something to keep my arm elevated in the tent, and I think I'll bring a bunch of those breakable emergency ice packs. What else am I missing? I won't even need to bring the Scotch. I'll just bring my bottle of hardcore narcotics that the surgeon prescribed. LOL. It's funny, the Scotch and the drugs are the exact same price per bottle. I might catch that rainbow colored Pike I've been dreaming about afterall.

 
manmountain8
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05/08/2018 04:18AM  
bobbernumber3: "
mastertangler: "One thing is for sure..........if you go we all want to know how it went, for better or worse. Sort of like a reality show. ("and then the big fish ripped the rod from my injured hand and it dropped overboard" etc. etc. ) "



I haven't read this too closely, but I think I'd be waiting till a later date. Anyway, have a great time and for sure report back on your success!"


I won my permit in the lottery. There is no waiting for a later date.
 
mastertangler
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05/08/2018 05:48AM  
Details.........I like that you are focusing on the minutia, the details of what you need and how it needs be done. I think that will make the difference.

FWIW the great Napoleon was credited with shrewd battlefield prowess and inspiring confidence with his troops. But largely what made him successful was attention to details. His troops always had what they needed, even down to the correct nails to build bridges if the need arose, and they were always well fed (a hungry army marches on its belly). And, like you, he kept his arm pinned to his chest (LOL, i'm kidding!).
 
PatrickE
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05/08/2018 04:36PM  
Glad to hear everything went well. Keep that arm elevated and get those fingers moving (as long as your surgeon has cleared you to do so)! It sounds like your plan is to make this trip happen so be safe and let us know how it turns out.
 
thlipsis29
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05/11/2018 07:44PM  
I'm just bumping this to the top because if I read it right, he went in today. Looks like he should have much better weather than we're having in southern MN. And I really do hope he posts some pics and shares what his experience was like. This was one of the more lively threads as of late :^)
 
revile63
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05/12/2018 09:51PM  
Long story short, I severed two tendons in my left hand day 2 of a 7 day trip. I still out fished everyone in my group, and even paddled up a small rapid. It depends on your attitude and your fortitude. It sounds like nothing is going to stop you from making this trip happen, so I think you'll be fine. Good luck.
 
mastertangler
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05/13/2018 08:57AM  
revile63: "Long story short, I severed two tendons in my left hand day 2 of a 7 day trip.
"


Bum deal. How did that happen if you don't mind me asking? Life is to short to make all the mistakes so I like to learn from others experiences.
 
PatrickE
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05/24/2018 04:34PM  
Just checking to see how the trip went and how the arm is coming along. Hope it was fun and pain free.
 
QueticoMike
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05/24/2018 04:48PM  
Post some fish pictures if you can too, thanks! Hope all went well.
 
manmountain8
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05/25/2018 09:45PM  
The trip went pretty well. Although the tendons were severely damaged I didn't have much pain after the surgery as long as I didn't use my arm or hand. Thursday night in the bunkhouse at Packsack that all changed. I was up tossing and turning with throbbing pain and I had to get up and pee like 30 times. Friday morning we loaded the boat up and they took pitty on me and said it was ok to bring some extra stuff, like some heavy duty cots to sleep on. They must have regretted it because I got scolded for bringing too much stuff on the way out. LOL. We payed them to portage for us but we had to help and now we had to portage 2 boats. I questioned the logic the whole time but we couldn't have done the heavy lifting without them. Riding in the boat on the way out there I noticed that I could suddenly move my fingers much more. We arrived in the late afternoon to our camp site in Back Bay and were greeted by loons diving for fish, Bald Eagles catching fish, and big fish exploding on the surface. Things were looking up.

Friday night was cold. Below freezing. I layered up, zipped my Coleman 25 degree bag up over my head and slept like a baby. Opener morning was still cold and even after it warmed up the fish were very sluggish. Pike kept slashing at the bait but I rarely even felt them hit, much less get a hook in them. If I had it to do over I would have fished nothing but deadbait on Saturday because as we discovered later, it worked. We fished real slow with 5" Big Hammer swimbaits on 3/8 oz swimbait jigheads and started catching them. We had to let it drop really slow. I had to cast left handed which gave me about 60% of my potential and no accuracy. I also had to use the harness to land fish but by mid day I could hold the rod to work the bait. My dad was really rusty and not doing well. He's not an avid fisherman like me. I caught about 20 that day and he got 3. I did get follows from 3 10+ and 1 fish pushing 20 lbs but the biggest fish caught was only about 8 lbs so we were both a little disappointed. I was so worried about ice and snow that I didn't even think about bug repellent and sunscreen. I got fried on the first day and had to wear a coat in the heat the rest of the trip. The Boundary Waters must be the only place on earth where you have to deal with freezing temps, sunburn, and mosquitos all in the same day. The mosquitos are the size of horse flies too. I thought they must be males, right up until they started biting me.

Saturday night was cold again but Sunday warmed up a bit and the fishing picked up a bit too. We still mostly fished swimbait jigs but we didn't have to go as slow. I caught about 45 Pike that day and my dad got about 15. I started landing fish with out the harness. I just had to dig the butt of the rod into my gut and really only use my fingers to hold the rod. I started casting right handed too but it was real sore by the end of the day. Overall the fish were getting bigger but still nothing real good, yet. We did start catching some big Largemouth though which was a nice bonus. One of them that spit the hook at the boat was a real pig. Probably 6 lbs plus. The others were around 5. We also got into some Huge Bluegills and little Bass from shore and deadbait Pike right from our camp. The shallows behind our camp were loaded with every kind of fish in the lake. I saw thousands of little perch, some crappie and I even caught a little walleye on my sunfish rod and a worm, but it flipped off the hook at my feet. The whole area was teeming with life. Giant snapping turtles, painted turtles, peepers of every kind, little mammals scurrying all over, big birds of prey everywhere, Seagulls, eagles swooping right over our heads. It was interesting to see so much change as it warmed. Pike were exploding on the surface more and more. That night we came back to discover our camp had been ransacked by huge Ravens. One sat in a tree by our fire pit and heckled us as we ate our sunfish and rice dinner. It seemed to be mimicking different sounds it had heard in the forest, including a human voice, and digital sounds. It was bizarre.

On Monday it was much warmer and the fish started erupting much earlier in the morning, so I figured it was time to try something a little more aggressive. I tied on some 5" Savage Gear Bluegill swimbaits and we never even changed lures once after that. I got fish on the 1st 3 casts and it went like that all day. My dad actually started outfishing me. I kept watching how he was working the lure but he just kept outfishing me about 4 to 1. I think it was the Dark Gill pattern that he had with some extra color by the gills. Mine was the light gill pattern that is just more plain and green. At one point he got 5 in a row and just wanted to take a break and have a drink, but he made the mistake of leaving his lure dangling over the edge of the boat, and he caught another one. We had one hell of a day. I have no idea how many we caught. Hundreds of Pike and we got some more of those huge Largemouth. We got to see a Black Bear too. That was pretty cool. We did wind up achieving our goal of catching a trophy Pike and by we I mean, my dad got two of them. My biggest Pike was probably just over ten lbs but the old man did it. Twice. For all I knew he just had another 8 lber. There wasn't much of a fight happening and I wasn't even paying attention. Then I saw it next to the boat and I said holy sh#$ I'll get the net. It had actually just meandered over to our boat to have a look at us, then it decided it didn't like us and took off, peeling out about 30 yards of drag. That one was over 40 inches. That would have made the trip right there but then he went and did it again in a shallow spot on the way out to Hoist. The 2nd one was 39" but it might have actually been heavier. That night I slayed them by our camp while the old man licked his wounds but I could only manage a 34"er. At least the old man got a trophy. That repro will look good next to his 24.5" smallmouth he caught on Jackfish in 2014.

He said it was a lot more work than he had envisioned and at 72 years old, that may have been his last trip to Basswood. He spent every summer up there from 1952 when he was 5 until they got kicked out in 1964. He told alot of stories about running around the streets of Winton as a kid and hitchhiking to Ely. I also found out that he went back 4 times after the Wilderness act. 3 times with friends and once with a girl. Hmm, I had no idea. I tried to get him to go for decades but he was too bitter about losing the Lodge. I wonder if he'll go again if I get another permit next year?



 
manmountain8
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05/25/2018 11:20PM  
QueticoMike: "Post some fish pictures if you can too, thanks! Hope all went well."


















 
manmountain8
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05/26/2018 12:15AM  
Sorry for making everyone wait. I've been busy at work and at home trying to catch up. Thanks to everyone who helped out with some advice.
 
BearRaid
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05/26/2018 06:46AM  
Thank you for the great report and fish pics. I am glad you ended up having a great trip. Very nice pike and largemouth there.
 
thlipsis29
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05/26/2018 07:05AM  
Thanks for letting us know how it went. Not sure I would have gone in if I were in the same situation, but I give you a ton of credit for making the best of what could have been an awful situation. Nice fish and you have a trip you'll never forget! Hope you don't ever have to go through something like this again.
 
QueticoMike
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05/26/2018 07:52AM  
Looks like it all turned out well! Thanks for sharing!
 
PatrickE
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05/26/2018 12:01PM  
Glad you made it without incident. I kept looking for a pic of how well your cast held up!
 
mastertangler
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05/26/2018 04:52PM  
What happened to the guy with the broken arm? The whole thing was a set up.....a scam to get some sympathy and a few good fishing spots! Cant trust anybody these days (Just ask Trump ;-)
 
manmountain8
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05/26/2018 07:02PM  
PatrickE: "Glad you made it without incident. I kept looking for a pic of how well your cast held up!"


The splint was fine. I had a vacuum sealed rubber cover to keep it dry. I got a removable brace 2 days after I got back. Now that I can see it and feel it more I've noticed that the Ulna seems to be displaced. The bump on the back of wrist is turned to the side and the bone is sticking out an extra 1/8th inch compared to me other arm. It is still deformed too. They said the xray looks fine and they thought it was just swelling but it isn't. I've been leaving messages with the surgeon's assistant's but I can't get a response. I don't have another appointment until June 20th and I don't know what to do.
 
PatrickE
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05/27/2018 08:13AM  
Only thing I can tell you is keep trying to get in touch with the office if you're having issues. If all else fails, show up at the clinic and let them know you need to be seen.
 
manmountain8
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07/12/2018 02:41PM  
PatrickE: "Only thing I can tell you is keep trying to get in touch with the office if you're having issues. If all else fails, show up at the clinic and let them know you need to be seen. "

I saw the surgeon and took more x-rays. He said everything is just fine and dandy and he did such a wonderful job on my horribly damaged wrist. LOL. What a joke. My wrist is badly deformed and permanently tilted 20 degrees towards the pinky. The Ulna is sticking out of my arm and extra 1/4 inch and twisted outward. It took 20 minutes of badgering him just get him to admit the gap between the Ulna and Radius is "slightly" wider than it should be, but of course he says it's perfectly fine and shouldn't give me a problem. He says all of that is probably due to ligament damage. My wrist is absolutely locked up. I'm doing physical therapy and the more I try to work it the worse it gets. At times I can't use my hand for anything. Can't even hold a fork. Does this sound like accurate information to you? Should I go get a 2nd opinion?
 
thlipsis29
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07/12/2018 04:22PM  
Don't know if there is any way you can get a referral to Mayo Clinic, but I wouldn't be happy if I was in your shoes. I know a few people who have come to Mayo to have previously bothced surgeries corrected, and didn't know why they waited so long to do so. Sorry that you have to go through all of this crap. Hopefully these issues can be addressed and healed before your next trip. Truly wishing you the best!
 
old_salt
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07/12/2018 07:15PM  
I agree with going to Mayo. Just give them a call. Bring your medical records and insurance information.
 
PatrickE
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07/12/2018 07:29PM  
Can't give you any advice on the specifics of your case. I will say that anytime a patient is unhappy with an outcome/my care, I encourage them to seek a second opinion and see what else can be offered. Most physicians are very encouraging of this. Same as you, just want you to get better and improve. Good luck.
 
mastertangler
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07/12/2018 08:43PM  
Dude that sucks.

Stay optimistic. Do what you can to create a positive outcome.
 
manmountain8
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07/13/2018 01:56PM  
PatrickE: "Can't give you any advice on the specifics of your case. I will say that anytime a patient is unhappy with an outcome/my care, I encourage them to seek a second opinion and see what else can be offered. Most physicians are very encouraging of this. Same as you, just want you to get better and improve. Good luck. "


Is it normal for the Ulna to be displaced by a 1/4 inch and twisted? Can the wrist joint work if it's that far off? Would you agree that this shouldn't pose a problem? Can ligament damage cause this as they have inferred?
 
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