A female patient with severe shoulder and arm pain and deformity visited Dr.Saurabh Talekar, an orthopedic surgeon in Kandivali, Mumbai, at Wholistic Care Centre.
She had a fall due to which there was localized pain in the arms and shoulder and a limited range of motion. She was unable to raise her arm or perform any activity.
She had consulted another doctor who had recommended surgical intervention.
Assessment
Dr. Saurabh Talekar did a physical examination, and X-rays were taken. X-ray is the standard diagnostic method to verify a fracture, and mainly two different angles of view are taken to help analyse the pattern of the fracture. The x-ray showed a fracture in the proximal humerus.
After clinical assessment, Dr. Saurabh Talekar suggested a conservative treatment using a hanging cast to address the fracture.
Conservative treatment for fractures
Conservative fracture treatment is not quite common nowadays, with orthopedic surgeons and patients opting for surgical interventions.
However, conservative fracture treatment offers less trauma and complications. and the results are similar to the operative method.
Further, the cost of the treatment is considerably less as it does not require surgery.
Traditional conservative fracture management is based on three main principles: fracture reduction, fracture stabilisation, and keeping the fracture stabilised with a cast or splint until it heals.
Using conservative treatment with a hanging arm cast requires accuracy and precise attention to detail. The orthopedic surgeon will reposition the fragmented bone, close the wound if necessary and then apply a cast or splint to secure the bones in place.
Immobilisation helps to reattach the bones and aid with the healing process. The doctor tries for early mobilisation to avoid joint stiffness.
Treatment provided
With the patient’s consent, Dr. Saurabh Talekar, a prominent orthopedic surgeon in Kandivali, Mumbai, went ahead with the conservative treatment of the fracture. He placed the arm in a hanging cast.
He called the patient for regular follow-ups to monitor the progress. After a week, he asked for an x-ray, which showed signs of healing.
We took an x ray to confirm reduction at one week. At 3 weeks there were signs of consolidation of the fracture
Then the cast was removed, and the patient continued using slings for another three weeks. Dr. Saurabh Talekar asked her to move the hand in a pendulum movement.
During the seventh week, the patient could move the arm behind her back and perform internal rotation during the follow-up treatment.