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Is surgery needed to fix my mother's broken arm?

Q: My 56 years old mother, who is diabetic and hypersensitive, broke her left arm bone (above elbow) recently. I consulted two ortho-surgeons. One of them suggests that we can plaster her arm and wait for a month and if she recovers, it is ok; otherwise we shall have to operate and put steel plates. The other doctor says that we should not waste time for plaster recovery and should immediately go for a surgery. I am in a dilemma. Kindly suggest whether we should wait for a month or not? Further, are there any chances of extra growth of bones, which might create problems in operating afterwards? Is recovery at this age not possible without surgery?

A:Your mother is only 35 kg and she is also diabetic and hypertensive. The decision to operate a humeral fracture is based on the level of the fracture and whether it involves the joint or not. Another point of consideration is whether or not the type of displacement of the fracture be reduced and maintained. We also have to see if after plastering, the fracture reduction can slip easily or not. Sometimes, plastering is not possible because of skin conditions. A lot of people prefer early fixation of fractures to facilitate early mobilisation of joints to prevent stiffness. However, no surgery is without risks, especially your mother being a diabetic and a hypertensive, her risk for pre- / post-operative problems is definitely higher than a normal person. The time for healing does not change irrespective of surgery or plastering. In fact, surgery if it gets infected can actually delay healing. If conservative treatment is being done then we normally wait for 4-6 weeks to see there is any evidence of fracture healing (by way of callus forming) on X-ray or assess clinically at the end of six weeks to see if the fracture is getting sticky and if it is still mobile then we can operate.

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