50% displaced humerous - Doctor opinions?

brocsdad
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brocsdad
Edited Date/Time 3/23/2018 11:46am
Hello,

My friends son high sided over a double at Windham's qualifier and suffered a dislocated shoulder and fractured humerus. They said it was 50% displaced. At the ER in LA 2 of the docs wanted to operate but they stabilized it until he could return home in TN. The doc at Vanderbilt did not want to operate but they also questioned his evaluation because it did not seem very thorough.

He should have the X-Rays back hopefully in the next day or so and I was curious if there are any docs that frequent the forum and would offer their opinion.

I will ask him to upload the X-Rays once his receives them.

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tobz
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tobz 3/20/2018 2:12pm
3/20/2018 2:12pm
I would aaah get more opinions if you feel the need, but probs not on here.
brocsdad
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brocsdad 3/20/2018 2:15pm
3/20/2018 2:15pm
tobz wrote:
I would aaah get more opinions if you feel the need, but probs not on here.
In the past a few docs would chime in on Vital so I was hoping someone may see the post and offer their opinion.
Motocross Kid 3/20/2018 4:03pm
3/20/2018 4:03pm Edited Date/Time 3/20/2018 8:07pm
Here's my displaced proximal humerus fracture (post surgery):



I would encourage a MRI at minimum, CT scan at best and get the opinion of an orthopedic surgeon that specializes in shoulders if you have the option. It really depends on where the humerus is broken. There are two critical joints on either end. My break threatened to severely impact the use of my arm given the location. A more central break might not be that big of a deal with regards to range of motion.

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gwillie450
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gwillie450 3/20/2018 4:49pm
3/20/2018 4:49pm
I broke mine there last year ( Brett Cue hit me in the air over the first line) . They put a plate and 8 screws in it in July it is the worst experience in my life. Get a good orthopedic surgeon and make sure they check his vitamin d. I have been dealing with this for a year if you have any questions pm me.
swatdoc
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swatdoc 3/20/2018 6:05pm
3/20/2018 6:05pm Edited Date/Time 3/20/2018 6:08pm
Let's see the x-rays, but I'd suggest a thorough eval by a good orthopedic surgeon in your area, and if possible, one that does a lot of work with college/profession athletes - quite often they will be very current on the latest techniques and procedures, and understand the needs of an athlete better. My ortho is the lead guy for the UH football team, and was a QB with the Chargers and 49ers back in the day.
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GuyB 3/20/2018 6:07pm
3/20/2018 6:07pm Edited Date/Time 3/20/2018 6:10pm
Asking for medical advice here may not be your best play. Smile

But...if it's displaced at all, wouldn't that be 100%? I'm not sure where 50% comes from.
BobPA
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BobPA 3/20/2018 6:23pm
3/20/2018 6:23pm
Man, sorry to hear about this...Been a rough go for your son lately. Did you guys end up on the TM?

Hope he heals soon
ktm150
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ktm150 3/20/2018 6:27pm
3/20/2018 6:27pm
Get more opinions. I also had a proximal humerus break about a year and a half ago. Most surgeons wouldn't touch it. Got lucky and got an amazing surgeon to finally do it. Have zero pain now and 100% movement

brocsdad
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brocsdad 3/20/2018 7:07pm
3/20/2018 7:07pm Edited Date/Time 3/20/2018 7:09pm
BobPA wrote:
Man, sorry to hear about this...Been a rough go for your son lately. Did you guys end up on the TM?

Hope he heals soon
It’s not my son but a good friend of ours. He just got a new TM and was killing it on Friday and then crashed on the 1st lap of Saturday’s practice before the motos started. We normally ride and travel to the track together. Again since this injury is outside of the norm I decided to post a thread to see if anyone with a like injury or doctor would weigh in on their experience.
brocsdad
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brocsdad 3/20/2018 7:11pm
3/20/2018 7:11pm
swatdoc wrote:
Let's see the x-rays, but I'd suggest a thorough eval by a good orthopedic surgeon in your area, and if possible, one that does a lot...
Let's see the x-rays, but I'd suggest a thorough eval by a good orthopedic surgeon in your area, and if possible, one that does a lot of work with college/profession athletes - quite often they will be very current on the latest techniques and procedures, and understand the needs of an athlete better. My ortho is the lead guy for the UH football team, and was a QB with the Chargers and 49ers back in the day.
As soon as he has the X-rays we will upload them.
c0ncEpT
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c0ncEpT 3/20/2018 7:30pm
3/20/2018 7:30pm
I dislocated my shoulder and ended up having a greater tuberosity(head of humorous) fracture last year.

It was non displaced so I didn't get surgery. I'm like 9 months post injury right now and it feels about 90% better. It would probably be 100% if I took the time to do the PT I should.


Motocross Kid 3/20/2018 8:10pm
3/20/2018 8:10pm
gwillie450 wrote:
I broke mine there last year ( Brett Cue hit me in the air over the first line) . They put a plate and 8 screws...
I broke mine there last year ( Brett Cue hit me in the air over the first line) . They put a plate and 8 screws in it in July it is the worst experience in my life. Get a good orthopedic surgeon and make sure they check his vitamin d. I have been dealing with this for a year if you have any questions pm me.
Yeah man, I sympathize. The PT was absolutely brutal. My physical therapist said this injury is just about the most painful to recover from given the work they have to do to regain range of motion. It was torture on a daily basis for quite some time. Definitely took a toll mentally.
kkawboy14
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kkawboy14 3/20/2018 8:16pm
3/20/2018 8:16pm
My medical opinion is that there is nothing humorous if it’s 50% displaced!
Motoxdoc
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Motoxdoc 3/20/2018 10:41pm
3/20/2018 10:41pm
50% displaced? I've never even heard of that term being used. I fractured my humerus at 16y/o. Complete and pretty well displaced (in 2 with a couple small pieces floating around), and I didn't have surgery....and I've had no problems since. Surgery will cost more, but you'll get better alignment...which means the bone callus won't be as big (lumpy bone deposit around fracture site) but you'll end up with hardware. Once surgery is completed you don't need to be as careful as you would for the first 2 weeks without surgery and you can probably get back on the bike a week or 2 sooner with surgery (I'm sure this is a big factor in the pros decision process). Sometimes hardware aches when it gets cold, although I have 33 screws and 4 plates in my left tibial plateau and lower tib/fib...and it doesn't bother me a bit. I can run 5K's and it usually dosen't set off metal detectors. Then there's always the option of removing the hardware. There are pros and cons both ways. I myself am glad I didn't have surgery on my humerus when I was 16y/o...but my tib/fib was another story. BTW, my fractured humerus wasn't very painful at all to recover from....compared to my crushed calcaneus or tib plateau! The closer the fracture is to the center of the bone the better. It's more likely that the dislocated shoulder will cause more long term problems.
BobPA
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BobPA 3/21/2018 1:52am
3/21/2018 1:52am
BobPA wrote:
Man, sorry to hear about this...Been a rough go for your son lately. Did you guys end up on the TM?

Hope he heals soon
brocsdad wrote:
It’s not my son but a good friend of ours. He just got a new TM and was killing it on Friday and then crashed on...
It’s not my son but a good friend of ours. He just got a new TM and was killing it on Friday and then crashed on the 1st lap of Saturday’s practice before the motos started. We normally ride and travel to the track together. Again since this injury is outside of the norm I decided to post a thread to see if anyone with a like injury or doctor would weigh in on their experience.
Good call, I just reread the initial post...guess I skipped some important details...
Motocross Kid 3/21/2018 9:55am
3/21/2018 9:55am
Motoxdoc wrote:
50% displaced? I've never even heard of that term being used. I fractured my humerus at 16y/o. Complete and pretty well displaced (in 2 with a...
50% displaced? I've never even heard of that term being used. I fractured my humerus at 16y/o. Complete and pretty well displaced (in 2 with a couple small pieces floating around), and I didn't have surgery....and I've had no problems since. Surgery will cost more, but you'll get better alignment...which means the bone callus won't be as big (lumpy bone deposit around fracture site) but you'll end up with hardware. Once surgery is completed you don't need to be as careful as you would for the first 2 weeks without surgery and you can probably get back on the bike a week or 2 sooner with surgery (I'm sure this is a big factor in the pros decision process). Sometimes hardware aches when it gets cold, although I have 33 screws and 4 plates in my left tibial plateau and lower tib/fib...and it doesn't bother me a bit. I can run 5K's and it usually dosen't set off metal detectors. Then there's always the option of removing the hardware. There are pros and cons both ways. I myself am glad I didn't have surgery on my humerus when I was 16y/o...but my tib/fib was another story. BTW, my fractured humerus wasn't very painful at all to recover from....compared to my crushed calcaneus or tib plateau! The closer the fracture is to the center of the bone the better. It's more likely that the dislocated shoulder will cause more long term problems.
This is common with humeral head fractures to quantify how much the head of the humerus is displaced relative to the shaft of the humerus. Fractures with less than 50% displacement can sometimes be left to heal on their own without surgical intervention. Sounds like this particular case is right on the edge, which is why a shoulder specialist would be ideal.
brocsdad
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brocsdad 3/21/2018 10:02am
3/21/2018 10:02am Edited Date/Time 3/21/2018 10:03am
Motoxdoc wrote:
50% displaced? I've never even heard of that term being used. I fractured my humerus at 16y/o. Complete and pretty well displaced (in 2 with a...
50% displaced? I've never even heard of that term being used. I fractured my humerus at 16y/o. Complete and pretty well displaced (in 2 with a couple small pieces floating around), and I didn't have surgery....and I've had no problems since. Surgery will cost more, but you'll get better alignment...which means the bone callus won't be as big (lumpy bone deposit around fracture site) but you'll end up with hardware. Once surgery is completed you don't need to be as careful as you would for the first 2 weeks without surgery and you can probably get back on the bike a week or 2 sooner with surgery (I'm sure this is a big factor in the pros decision process). Sometimes hardware aches when it gets cold, although I have 33 screws and 4 plates in my left tibial plateau and lower tib/fib...and it doesn't bother me a bit. I can run 5K's and it usually dosen't set off metal detectors. Then there's always the option of removing the hardware. There are pros and cons both ways. I myself am glad I didn't have surgery on my humerus when I was 16y/o...but my tib/fib was another story. BTW, my fractured humerus wasn't very painful at all to recover from....compared to my crushed calcaneus or tib plateau! The closer the fracture is to the center of the bone the better. It's more likely that the dislocated shoulder will cause more long term problems.
Motocross Kid wrote:
This is common with humeral head fractures to quantify how much the head of the humerus is displaced relative to the shaft of the humerus. Fractures...
This is common with humeral head fractures to quantify how much the head of the humerus is displaced relative to the shaft of the humerus. Fractures with less than 50% displacement can sometimes be left to heal on their own without surgical intervention. Sounds like this particular case is right on the edge, which is why a shoulder specialist would be ideal.
Thanks for the reply's!

His father is looking into a shoulder specialist. Like I mentioned before we are not looking for anyone on vital to perform the operation Smile I just though it may beneficial to get some feedback on what others have gone through. Again he will post the x-rays once he has the disc from LA.

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Badd127
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Badd127 3/21/2018 2:40pm
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kkawboy14 wrote:
My medical opinion is that there is nothing humorous if it’s 50% displaced!
Grinning well played sir
MDMCG
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MDMCG 3/21/2018 3:09pm
3/21/2018 3:09pm
Greater Tuberosity, humeral neck, humeral shaft, hill sach's with 50% impaction fracture, etc? Talking about this without pictures is just about useless.
SweetDaddy
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SweetDaddy 3/22/2018 10:29am
3/22/2018 10:29am
Broke my humerous in 2004 in two places and too close to the elbow to insert a rod. Plated it and good 2 go.
brocsdad
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brocsdad 3/23/2018 7:16am
3/23/2018 7:16am Edited Date/Time 3/23/2018 7:17am
X-Rays Posted! They are seeing another doc today so hopefully I will have some better ones.





GeorgiePorgie 3/23/2018 7:49am
3/23/2018 7:49am
Tough call there. One opinion might be to let it heal then try to put it back in. Another might be plate it and put it back in at same time.

Go see a sports medicine or specialty ortho.
brocsdad
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brocsdad 3/23/2018 8:10am
3/23/2018 8:10am
MDMCG wrote:
Greater Tuberosity, humeral neck, humeral shaft, hill sach's with 50% impaction fracture, etc? Talking about this without pictures is just about useless.
posted
rmgsxr
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rmgsxr 3/23/2018 8:36am
3/23/2018 8:36am
My son at 13 years old broke his a little lower than that. It was not lined up at all. The first hospital said it needed surgery. They sent us to Children's Mercy Hospital and after sitting there for three hours they sent us home with a sling. They said if it was my old ass I would be in surgery but with a young kid it will heal and straighten out on its own. Sure enough, after a follow up two weeks later it was lined up way closer. No surgery and no pain at all now.
brocsdad
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brocsdad 3/23/2018 9:11am
3/23/2018 9:11am
rmgsxr wrote:
My son at 13 years old broke his a little lower than that. It was not lined up at all. The first hospital said it needed...
My son at 13 years old broke his a little lower than that. It was not lined up at all. The first hospital said it needed surgery. They sent us to Children's Mercy Hospital and after sitting there for three hours they sent us home with a sling. They said if it was my old ass I would be in surgery but with a young kid it will heal and straighten out on its own. Sure enough, after a follow up two weeks later it was lined up way closer. No surgery and no pain at all now.
After visiting the doc today for another opinion they said it would calcify and pull back together.
rmgsxr
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rmgsxr 3/23/2018 11:21am
3/23/2018 11:21am
rmgsxr wrote:
My son at 13 years old broke his a little lower than that. It was not lined up at all. The first hospital said it needed...
My son at 13 years old broke his a little lower than that. It was not lined up at all. The first hospital said it needed surgery. They sent us to Children's Mercy Hospital and after sitting there for three hours they sent us home with a sling. They said if it was my old ass I would be in surgery but with a young kid it will heal and straighten out on its own. Sure enough, after a follow up two weeks later it was lined up way closer. No surgery and no pain at all now.
brocsdad wrote:
After visiting the doc today for another opinion they said it would calcify and pull back together.
I hate for kids to have to have any surgery so it's good to hear that he may avoid it. Hope recovery goes well.
MDMCG
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MDMCG 3/23/2018 11:34am
3/23/2018 11:34am Edited Date/Time 3/23/2018 11:39am
That’s an impacted humeral neck fracture. Fixing that is 50:50 based on age and activity level. We fix a lot of those where I work to make it perfect and to allow for a quicker recovery. It does have drawbacks and risks though... also, his growth plates are open which may change their take on the matter....
Mit12
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Mit12 3/23/2018 11:46am
3/23/2018 11:46am
brocsdad wrote:
Hello, My friends son high sided over a double at Windham's qualifier and suffered a dislocated shoulder and fractured humerus. They said it was 50% displaced...
Hello,

My friends son high sided over a double at Windham's qualifier and suffered a dislocated shoulder and fractured humerus. They said it was 50% displaced. At the ER in LA 2 of the docs wanted to operate but they stabilized it until he could return home in TN. The doc at Vanderbilt did not want to operate but they also questioned his evaluation because it did not seem very thorough.

He should have the X-Rays back hopefully in the next day or so and I was curious if there are any docs that frequent the forum and would offer their opinion.

I will ask him to upload the X-Rays once his receives them.

From my experience unless this kid is a professional racer making money on the National Circuit he should get a second opinion and do what the doc says. I always cut what my doctors said the healing time in half and returned to racing. I am 55 now and I live in pain everyday. It is not worth rushing things unless you are at the top and even then it is a huge risk.

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