# Untreated Bone Fracture.



## TJ1985 (Jul 15, 2015)

I've got a character whom I'd like to portray as a real tough guy to the point of stupidity. I'm Mr. Wonderful, very good in bed, muscles in my t-shirt, nothing in my head. Not the brightest bulb in the box, but boy is he tough. (tuff!) 

So, genius breaks his wrist. Closed fracture, but it's broken (I'll work out how dimwit knows this as I get to it). He grasps it and "sets" it himself. Does a miserable job and doesn't set it right. Because he's a tuff hombre, he's not going to brace or splint it, and only wimps (and people with intelligence) go to the hospital. 

What's going to happen to boy genius if this were a real-world incident? I know in the future the hand will be nearly useless, but I'm curious about the short term implications, from the moment of fracture and DWF (dimwitfix) through one month. I'm thinking major swelling, significant pain, and the hand wont work. What else? I'm looking for the worst case scenarios of what could happen. 

If it helps, he's roughly 6'5", 290lb (131kg, 20 stone) and is very muscular. Say... 5% body fat. Thoughts?


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## musichal (Jul 15, 2015)

If it were a larger bone, there might be a risk of fat emboli, which could result in sudden death.  Not as likely with the relatively small bones of the wrist.

However, severe inflammation is very likely.  "My hands felt just like two balloons."  Looked like 'em, too.  The break would likely impair blood circulation.  The question is how much.  Severe impairment the fingernails turn blue quickly;  if blood flow is very severely occluded, then the hand itself may begin turning dark, even leading to gangrene.  

Nerve damage could work a couple different ways, either excruciating pain or little to no pain.

Perfect storm is nerve damage resulting in decreased sensation which restricts or blocks the pain, while the hand turns dark and the idiot thinks since it doesn't hurt too badly, it may improve on its own.


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## scrub puller (Jul 15, 2015)

Yair . . . 

*TJ1985

musichal *has covered all the downsides pretty well . . . but it does happen.

I have lived and worked in remote places for much of my life and particularly in PNG saw some misshapen limbs and wrists.

From my own experience stuck in floods with a broken wrist you are spot on with . . . . 



> major swelling, significant pain, and the hand wont work.



Cheers.


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## Pluralized (Jul 15, 2015)

Been stuck m'self with a broken wrist and ankle for extended periods in the wilds of Wyoming, and it's not pleasant. One, a broken wrist, I lived through. I'm not 6'-5 or anything, but pretty good in bed.

Swelling to the point of bursting or bone infection both seem like great drama-builders.


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## TJ1985 (Jul 16, 2015)

Thanks y'all, I appreciate it. I figured it'd swell crazily, possible compartment syndrome, etc. You guys helped me quite a bit.


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## Sam (Jul 16, 2015)

Stationary bones like a clavicle (collarbone) can be left to heal naturally without much problem, but bones that can be manipulated need to be set and cast by a doctor or they will never heal properly and, in some cases, create what's known as a nonunion or false joint that will require extensive surgery to repair. 

If your dimwit attempts to set the bone himself (which is a really, _really _dumb idea), with no knowledge of anatomy whatsoever, the pain will be so _excruciating _that morphine would struggle to alleviate it. There is no way in hell that he would be able to withstand it for long without going to a hospital. I don't care how tough or how high his pain threshold is -- the kind of pain from a non-immobilised broken bone is horrific. 

As to what might happen beyond pain -- the list is extensive: fat embolism, deep vein thrombosis, infection, hypovolaemic shock, septicaemia, crush syndrome, and even compartment syndrome (which usually leads to amputation). 

I have a hard time believing that anyone, even a character so dimwitted, would be so ignorant and moronic to get himself into that situation, and a harder time believing that he would last longer than forty-eight hours without medical treatment.


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## Olly Buckle (Jul 16, 2015)

Wrists and ankles are complicated, lots of small bones and muscles interacting. In terms of larger bones I remember reading about an excavation of a Medieval graveyard where about a third of the skeletons had healed, or partly healed, unset breaks of major bones, so I guess Sam has it right as usual


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## scrub puller (Jul 16, 2015)

Yair . . .

*Olly Buckle

*


> and a harder time believing that he would last longer than forty-eight hours without medical treatment.



No, *Sam* doesn't have it right . . . posts from *Pluralised* and *scrub puller* must be invisible. (wry grin)

Cheers.


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## Olly Buckle (Jul 17, 2015)

scrub puller said:


> Yair . . .
> 
> *Olly Buckle
> 
> ...


It was this:- "Stationary bones like a clavicle (collarbone) can be left to heal naturally without much problem, but bones that can be manipulated need to be set and cast by a doctor or they will never heal properly and, in some cases, create what's known as a nonunion or false joint", that seemed to confirm the graveyard evidence. Mind you the OP specificlly mentioned 'wrist', so you two are bang on. When I broke my leg I noticed that breaks in major bones were repaired with a metal implant, the guys on the wrd who had broken wrists and ankles still had to wear a support, though not an old fashioned plaster, and were in for much longer.


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## musichal (Jul 17, 2015)

I broke my right radius  once, thinking it merely sprained.  Went to a clinic the next day, convinced it was, indeed, broken.

A right metacarpal I splinted myself.

Four ribs fractured in a car wreck one night.  Was at work next morning.  Had to stop breathing for a couple weeks. 

You can set your own fingers if they aren't bent too badly, or crushed - who hasn't done that.

Never broke any larger articulating bones, thank god.


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## TJ1985 (Jul 17, 2015)

musichal said:


> Never broke any larger articulating bones, thank god.



Aww shucks, you're missing out Hal.  

I really appreciate the help y'all. I'm thinking maybe one of the metacarpals might be a better choice. I need the big oaf to be at a disadvantage to "explain away" his inability to defeat an enemy, but I don't need him in the fetal position in the corner, lol. 

Thanks.


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## Cran (Jul 17, 2015)

I had a triple fracture of my ankle which was never set. I thought it was sprained, but when the pain on standing/walking didn't settle out after three months, I saw my doctor about it. X-rays confirmed the fractures, and I was sent off for a bone density scan. 

When I was a teenager, I broke my arm and wrist in a sporting accident - it looked like an upside down square root sign. I didn't feel anything when it happened. The pain afterwards was much like a minor sprain. It hurt more after it was set and my arm swelled up inside the cast. 

If the character's wrist fracture is anything like my ankle, it would sporadically (and unexpectedly) hurt like hell if he put any weight or pressure on it - lifting, leaning on the table, pushing open a door, etc - for months, if not years afterwards.


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## musichal (Jul 17, 2015)

yeah, a metacarpal simple fx should work fine for your scenario


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## scrub puller (Jul 17, 2015)

Yair . . .

Resolved! (big grin)

Cheers.


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## TJ1985 (Jul 17, 2015)

Thanks to all of you for helping. We humans can be fragile at times.


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