willy81 said:
in my opinion all those non-unions even with the surgery is BAD medical practice. Simply, the Doctor did not do his job properly. Non-unions can happen when soft tissue of the surrounding area of the fracture site intervenes between the two bones. It is Doctor's job to clean the fracture site and make sure that no soft tissue will enter there. If he does not do it correctly non-union will happen. Bad medical practices we have in many cases this does not mean that we must avoid doctors, instead we better find a Doctor with good reputation. This is an other reason to have your plate/screws eventually removed after a certain period of time because in the second operation your Doctor will be able to check thoroughly if a perfect Union has taken place or not.
First, let's reinforce to the peanut gallery that you are not a doctor, so what you know about the treatment of non-unions and the possibility of a plate (or other such device) to break is very limited at best and more likely seriously flawed. First, it is entirely possible and not at all rare for non-unions to not heal when plated or otherwise treated. This happens a lot more than you know. Why it happens is the result of many things: other injuries incurred in accident; patient medical history; conditions resulting from surgery, and on and on and on. Things like decreased circulation, swelling, diseases that slow healing, compartment syndrome, and even things as simple as the type of fracture affect how something will heal and if it will need further intervention (surgical or otherwise). Moreover, surgery itself can slow or impede healing. Surgery can disrupt blood flow in the periosteum, the bone layer that is essential in healing of a fracture. THIS is a big reason why orthopods aren't always eager to jump in and start cutting. It's entirely possible that a bad break will heal more slowly after surgery than it would have otherwise. Every screw, drill bit, or summat that goes through a bone disrupts that periosteum and potentially slows healing or disrupts such that more intervention is needed. Second, metal plates, rods, and other bits, can and do break and bend. It is rather common occurrence, for instance, for motorcycle racers and bicycle racers to break clavicle plates, even without crashing again. I've seen reported more than enough. I've had happen to friends. People--and specifically you--likely have very little concept of the large forces and moments that can be placed on a component of a human skeleton, let alone on orthopedic hardware. I was repeatedly warned by orthopod about the possibility of me breaking or bending a titanium rod that had been hammered into intermedullary space of my, at the time, 7 piece tibia. It was hammered into me that until the bone healed the risk of such a mechanical failure was high. It was hammered into me that the it was not an uncommon thing. Feel free to google intermeduallary tibia rod and compare it's dimensions with that of a plate for a clavicle. Granted the forces and moments on that rod are likely a lot more than on a clavicle plate, but don't be so quick to poo-poo and discount the magnitude of the forces and moments that can be generated on a clavicle plate. There is absolutely no reason at all to leap to an accusation of malpractice in the case of a plate breaking or a non-union occurring, especially when you have no medical training. Non-unions as mentioned before are absolutely not-uncommon. There are many reasons for a non-union to occur, and almost all of them have nothing to do with medical error. I lived with a tibial non-union for 1.5 years, through five surgeries, including the placement of a rod, the placement of an internal bone-growth stimulator, the removal of rod screws to make my rod dynamic (allowing my lower tibia to slide up and down on the rod as I walked to increase bone production at fracture sites), and placement of bone grafts, all because of the etiology of my injury. Mine is just one instance of a non-union that had absolutely nothing to do with malpractice. I'd suggest that you limit your "advice" and medical pronouncements to those things which actually have factual basis.
