Thursday, March 1, 2012

Interesting X-rays

As I wrote in the previous post, my brother was hurt in a cycling accident. We have no idea what happened except that he was apparently launched from his bike, landed in the road until someone called 911 and reported that an injured man was lying in the road. His bike was totally off the road and is not damaged. My brother is a different story. 

Since I work in the medical field, I was somewhat clinical when he first got hurt. I could list the injuries, discuss surgical options with the surgery team, discuss rehab, but it took me a little while to realize how HURT he was. 

The day after his shoulder surgery, the physical therapist, a nurse and I got him up to sit on a bedside commode for a few minutes. I stood beside him to make sure he didn't fall. He could not even hold his head up. You could tell he was in agony. It was heartbreaking. I just didn't realize the magnitude of injury to his body despite seeing all his X-rays, labs, etc. I guess I was being the clinician, not really a member of the family.

He is WAY, WAY better now. He has been in rehab for 5 days now and has come a long way. He will probably be there for 1-2 more weeks. He has to be able to transfer from the bed to a wheelchair before he can go home. He cannot bear weight on either his right arm (his dominant arm) or his right leg for about 3 months. 

Anyway, I thought you might want to see what his CT-scans of his most significant injuries look like. These are 3-D reconstructions of the scans so it is easier to visualize the damage. 

This is an anterior view of his fractured clavicle and scapula. You can see clearly see the crack in the collarbone and the large fracture running down the scapula. The posterior view photo below shows the scapula fractures better. 

You can see that the lower body of the scapula is displaced. When he was thrown from his bike, his weight on the shoulder pushed the upper part of the scapula and clavicle to the middle. The orthopedic team operated because it was not a stable fracture. His arm drooped when he sat up. So now he has screws and plates in the scapula as well as in his right hip. I don't have photos of the repair yet. I will do that though. 

These next two photos show the pelvic fractures. They are a little harder to see because the pelvis is round and bones overlap. 

This is the anterior view of the pelvis. You can see the fractures to the pubic bone. The hip joint on the left (you are facing the patient so his left is your right) is the way your hip should look (except for the pubic fractures). The head of the femur is well-situated in the acetabulum, the cuplike structure that forms the joint. 

The right hip is NOT right. Again when he landed on his right side, the ball of the femur punched through the hip joint. You can see it better on the posterior view below. This shows how far the femur went through the joint. 

Do see the fracture where the head of the femur is sticking in the pelvis through the joint?  The orthopedic surgeons did an absolutely beautiful job recreating his hip joint. I'll get a photo of that and show you guys later. 

The good news? Like I said he is doing way, way better. He is in surprisingly good spirits. Trying to figure out when he can get back on the bike (knowing that it is probably 6 months away.) He is really enjoying the visitors. He has occupational therapy and physical therapy most of the day. He is usually free by 5PM. The rehab hospital discourages visitors before 5PM. He is happy to text all day long so feel free to text him on his phone. 

We are so thankful he is doing so well. The accident could have been so much worse. His care has been wonderful. I've been very impressed with the staff at the hospital. That's where we are now. More updates in a few days. 


  1. WOW! He is lucky to have such a great team of doctors to repair his damage along with a great sister and family to support this recovery!

    I'd love to text him, but don't have his number. Could you send it to me?

  2. I'll call this weekend and give you his number. I work all night tonight. I will be off for a few days.