[AlanZ]

Rod for fracture loose due to porous bone - what now?

by AlanZ on Fri Jan 15, 2016 10:42 pm

Hello, I only just found and have been looking over this forum and this is my first post.

I was diagnosed in 2007 with multiple myeloma and had an autologous and an allogeneic transplant in 2008 then another allogeneic transplant in January of 2015. My numbers have fluctuated but generally been decent, except for just before the 2015 transplant, which is why I had it.

Since then my numbers seemed to be ok, though not great, and I have been on a maintenance regimen with dex and Revlimid, which was recently modified to dex and Pomalyst.

I had some pain in my shoulder which was chalked up to a pulled muscle or something, and was told to take Tylenol (acetaminophen, paracetamol) and when it got worse, was offered tramadol and other pain meds in the assumption it would get better. It didn't and in fact got worse.

After about a month, I took myself to a sports doctor who took a quick xray and she immediately sent me back to my oncologist since the xray showed a large lesion. Before anything could be done, the bone gave way and fractured at the lesion near the head of the humerus.

I received radiation at the site to stop the lesion and then a rod was placed to stabilize the break. Apparently the bone was porous in the area of the lesion, but the surgeon felt it should be strong enough.

Now (about 2 months later) the screw securing the rod is coming loose and I was wondering if anyone has any experience with this happening? Apparently this is probably caused by the bone being too porous and not healed enough to support it yet.

Does anyone know what happens now?

I have an appointment next week and will find out more and get more xrays, but I'd like to know more now but can't find any clear information on the web about this kind of incident, either clinical or anecdotal.

Thanks in advance for any thoughts or comments!

[Multibilly]

Re: Rod for fracture loose due to porous bone - what now?

by Multibilly on Sat Jan 16, 2016 4:53 pm

Hi AlanZ,

Let me begin by saying that I have no experience with this kind of surgery.

I also have no idea if your surgeon can re-stabilize your internal rod or not by using some clever procedure to give the loose screw something more to "bite" into. But if he can't, you may want to try googling "external fixation rodding surgery humerus" to better understand what other options might be available to you.

[Bar-none]

Re: Rod for fracture loose due to porous bone - what now?

by Bar-none on Sat Jan 16, 2016 6:25 pm

Hi AlanZ!

Sorry to hear about these issues. I would suggest locating an orthopedic oncologist who specializes in reconstruction and get their opinion. These doctors are typically specialized orthopedic surgeons. Most have dealt with myeloma fractures.

Keep us posted! BN

[NStewart]

Re: Rod for fracture loose due to porous bone - what now?

by NStewart on Mon Jan 18, 2016 4:02 pm

I would suggest an orthopedic oncologist or an oncologist who specializes in treating osteosarcomas. They would have the most experience treating people with bone problems due to cancerous lesions.

I hope that the problem is addressed successfully soon,
Nancy in Phila

[AlanZ]

Re: Rod for fracture loose due to porous bone - what now?

by AlanZ on Fri Jan 22, 2016 11:37 am

Thank you for the comments. I've been treated at MSKCC and went in to see the orthopedic oncologist as soon as was possible. We'll try removing the loose pin and allowing the bone to heal longer and then re-evaluate. There is the possibility the bone will not heal but the hope is the bone just needs time to regenerate more.

[Bar-none]

Re: Rod for fracture loose due to porous bone - what now?

by Bar-none on Fri Jan 22, 2016 8:35 pm

Thanks for the update AlanZ! Are you on any bisphosphonates such as Zometa? If not, you might ask your doctor about doing something along those lines also.

Our hopes and prayers are with you!

Best! BN

[vicstir]

Re: Rod for fracture loose due to porous bone - what now?

by vicstir on Fri Jan 22, 2016 9:16 pm

Dear Alan,

I have nothing to offer you on your situation. If I may ask you though about the treatment you have received to date and a little about your disease.

I note you have had two Allo's. Why?
Woud you say that your sct's have been worth it.?
Is your disease considered high Risk?
Did or do you have Graft V's Host?
Where you treatment free in between SCT's? until your latest Allo

I am sorry if these questions are intrusive but your answers could be of much benefit to those of us that have the option for Allo's in the future.

Thanking you.

Vicki