Hurray! … the x-rays showed smooth new white bone "stuff" filling in what were still big spaces 3 weeks ago. I thought the doctor would then just say "off with the sling and away you go" LOL – shows how much I know about broken upper arms and rotator cuffs.
There is to be no immediate ceremonial burning of the sling as I have to "wean" my arm out of it first. I will still sleep in it for another week as we "have the potential to damage ourselves while we sleep" said the doctor. The new bone is not hard yet – actually it's not even really "bone" yet.
The re-forming of bone is really interesting (and one of those things you don't think about until it affects you). When I fell over and broke the bone I also severed blood vessels which fairly quickly formed clots called fracture hematoma (I had bruising that extended from my armpit to my elbow). This clot stabilizes the bone and helps to keep the broken pieces aligned. The clot also cuts off blood supply to the jagged bone edges and these cells die and are carried away (I hope) by other cells.
Tiny new blood vessels develop and help the fracture hematoma develop into a soft callus. Cells called fibroblasts start producing fibres of collagen (the major protein in bone and connective tissue) and then osteoblasts produce bone cells which transform the soft callus into bone callus - this is the stage that I am now at. Bone callus is a hard shell which lasts 3 to 4 months and provides protection and stability for the bone as it continues to heal.
During this phase the position of the bone is set within the flesh and the body begins reabsorbing bits of dead bone at the same time it is bridging the gap with the hard callus. This bulge of hard callus can not take a lot of strain – Osteoclasts and Osteoblasts spend months remodeling and replacing the bone callus with harder compact bone. Cells then gradually decrease the callus bulge until the bone returns to its original shape.
After viewing the x-rays the doctor said: show me how high you can lift your arm (in a Roman salute motion) … Now bear in mind the last time I lifted my arm was 7 weeks ago today when I was washing my hair and putting my clothes on.
I tried; I really tried!! My fingers moved. I concentrated harder (my face most likely scrunched up and purple) – my brain was shouting at my arm but nothing much was happening. I laughed as I managed about 2 inches of lift!
The doctor smiled and said: this is why we do Physical Therapy. Apparently for every one day a limb is immobilized it takes about 3 days for it to get back its range of motion and strength. That's why I start "real" physiotherapy next week – no more of this sissy passive stuff!
So, now I spend a few hours each day without the sling building up until my shoulder can tolerate supporting the arm. The doctor suggested that I still wear the sling when I am outside the "controlled environment" (of home & office) for a couple more weeks. Personally I think I should go out like this: