How long to dive after broken bone?

[DevonDiver]

I fractured my 5th metacarple 3 weeks ago. The cast was removed today and I have begun rehab/physio to restore function to the little finger.

Other than soft tissue rehab, it is quite usable for diving (in terms of reqd function).

How long do I need to stay out of the water now? I am a dive instructor and am losing income every day I cannot work... but I don't want to jeapordise the long term strength and recovery of the break.

 

[DocVikingo]

Hi DevonDiver,

The diver with a broken metacarpal should be able to return to SCUBA following release for full use of the hand by the treating orthopedist.

Strength and range of motion should be within broad normal limits and activities with the affected hand not limited by pain.

Obviously care should be taken to prevent reinjury.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[Saturation]

Fractures, Surgery and Acute Conditions

The volume of bone as a source of excess gas may contribute to DCS because its altered state and circulation could trap gas and hence bubble out later, or a bone's abnormal state could increase DCS occurring within the bone itself, all in theory.

DCS seems very low risk given the size of the 5th metacarpal and doing gas loads typical of NDL dives. If it were I and I dove, I'd keep all my dives conservative and cut the maximum bottom time per depth to half until I'm fully healed. I think this is enough to get BOW students in and out of the water, but a little more risky for AOW level classes and a need for more depth.

My bigger concern is reducing a risk for osteonecrosis of bone, and among risky co-factors besides deep diving, and types of dives is prior DCS history, but there is low association between prior DCS and osteonecrosis. But, why risk it even if I never heard of osteonecrosis of a hand bone reported.

When full healing occurs is best and that is when pain free with normal range of motion and function.

 

[DevonDiver]

Thanks for those replies. I think my biggest concern was that of osteonecrosis, or some related condition that I had not heard of, where the presence and/or persistance of saturated nitrogen/microbubbles in the area of bone healing would cause areas of weakness in the healing and calcification of the bone.

The break hasn't caused any problems with circulation or the nerves, however, I have yet to regain a full range of motion in the joint (severe weakness on extension) and the 5th metacarpal itself is now deformed. A few weeks of physio and I expect to be given the all-clear

http://photos-e.ak.fbcdn.net/hphoto..._178842233538_704398538_2846120_3494874_n.jpg

 

[Saturation]

When the head of a long bone is broken, its often the hardest to heal and to get back into normal function. This is worse when the head is broken into many pieces.

For a diver, it would be good to be conservative to insure the bone heals as best it can, rather than for issues around DCS.