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Wednesday, January 21, 2015

Oh Dear - I broke both of the bones in my left arm! (Updated Jan 2015)

Ulnar fracture. Note minimal bleeding and swelling (circled) as a result of instant application of elevation.  Photo taken 10 days after the accident.
Several years ago I went for a run with my son, Alama and partner, Alofa. We came across a renovated playground and decided to take a break - literally. There was a rotating surfboard which 8 year old Alama mastered first shot. Being Dad, I had to outdo him. I did not realise until too late that my extra weight sent the device into an ever faster spin. My only option was to leap off and roll which turned out to be impossible, given the high speed spin.

The instant I landed on my arm I knew serious damage had been done. The jolt, the cracking sound and the overwhelming pain told me I was in serious trouble.  The pain was immediates and excruciating and I was overcome by waves of pain and nausea that had me fading in and out of semi consciousness.  But I managed to keep my head, quickly examining the arm as I lay there, determining that I had undisplaced fractures of the ulna and probably the radius. Fortunately, it was away from the wrist and no bones were visibly displaced.


After 10 days: Minimal signs of there having been any bleeding and swelling, meaning healing is able to commence within days of the accident.

First Aid
Simple, yet highly effective: I raised my arm above my head as I lay there and held it there with the assistance of Alofa. I knew that keeping the damage above the head will almost completely stop bleeding into the damaged area - No need for compression and no need for ice which is overrated as a first aid measure.


Site of fracture of radius. Note minimal bleeding and no swelling.  10 days after the accident.

After about 10 minutes, I felt able to begin the half hour walk back to our car. I did so with my arm still held above my head (with Alofa helping). Every now and then I had to lie down to avoid passing out the pain was so intense.


Immobilisation
I decided to self treat because I did not want to be immobilised for 6 weeks in a cast and suffer the loss of strength and wrist mobility.  The other thing I wanted to avoid was the hours of waiting in accident and emergency, further delaying treatment which I knew I could do myself to as good, or better standard.

While I lay at home with my arm still propped above my head, Alofa went to the chemist and purchased two broad rolls of cotton wool and two wide crepe bandages. These were used to form a 
double layered compression cast to prevent further bleeding and swelling into the damaged areas and to immobilise the bones. With little or no bleeding, the body's inflammatory processes could proceed with repairing the damage.

I maintained this immobilisation for just two days before stripping it off, shaving my arm and then strapping the arm with sports strapping tape as per the photo. After a further two days, I removed the strapping and commenced gentle massage to shift the swelling and cell debris to thus expedite healing.  Please be aware that I was pushing the limits all the way and should probably added a week or so to each stage.

Simple strapping place, replacing the home-made cast.  Early mobilisation while taking great care not to stress the fractures during healing.

Aiding recovery
I determined by gently palpating the site of damage that there was sufficient callousing of the fractured bones for them to be quite secure.  I commenced gentle exercise in the form of massaging clients mostly with my right arm but progressively with the left. 

Massage is the perfect progressive resistance exercise for such injuries. The gentle pressure 
though the fracture site stimulates the healing processes and preserves the muscles and other supporting structures as well as ensuring 
the wrist does not lose mobility.

Although it took some three to four months to feel I had 100% strength in the wrist, my recovery was about as rapid as could ever be expected.  In fact, I competed with some trepidation in an 80 km mountain bike race just four weeks into recovery, managing to finish 14th in a field of over 200 (This kind of stupidity is not recommended).  Not bad for an injured 55 year old, I reckon!

A month in and minimal swelling and no obvious loss of muscle or function. I was delighted!

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