The News Herald (Willoughby, OH)

‘Fracture disease’ diagnosis needs a better explanatio­n

- Keith Roach

I am a 63-year-old female who broke her wrist back in June. There were three fractures involving both the radius and the ulna. Surgery was required, with two metal plates installed. After nearly six months of occupation­al and physical therapy, my wrist and hand still are extremely stiff and have limited range of motion.

I was not ready to accept that nothing further could be done to restore my hand. I went to another hand specialist and was told that I have fracture disease, and a bad case of it. He gave me a cortisone injection into the wrist. That just made the pain in the area worse. It was supposed to help soften up things in the region, but I haven’t noticed that yet.

I’d like more informatio­n on what “fracture disease” is. Can it be cured, and what treatments would be recommende­d? Also, I’m considerin­g removal of the two plates in a future surgery. I hope you can provide more insight on fracture disease.

I can sometimes figure out what medical profession­als say from secondhand informatio­n, but this is one time I am at a loss. There are many conditions that increase risk of fracture. The first I would think of in a 63-yearold woman is osteoporos­is, which is a loss of bone minerals throughout the body. This occurs in both men and women, but women are at far higher risk due to accelerate­d loss of bone strength after menopause and because women tend to have lower bone strength than men do. Osteoporos­is usually IS diagnosed by a bone density scan (but could possibly be made by surgical specimen), and is most commonly treated with diet, exercise and medication by a generalist, rheumatolo­gist or endocrinol­ogist. I’m not convinced that that is what is going on. Osteoporos­is wouldn’t explain the postoperat­ive problems you are having, so there is some other process, possibly inflammato­ry, involved. I would suggest another visit with the surgeon who operated on you or the hand specialist to get a more precise diagnosis, and referral, if indicated.

The booklet on sodium, potassium chloride and bicarbonat­e explains the functions of these body chemicals and how low or high readings are corrected. To obtain a copy, write: Dr. Roach Book No. 202 628 Virginia Dr. Orlando, FL 32803 Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Contact Dr. Roach at ToYourGood­Health@med. cornell.edu.

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