Expert: Dawn Caceres Date: 5/27/2008 Subject: Torn muscle surgery
Question After a traffic accident most of my left pectolaris major was torn, I had some internal bleeding and initially had near no use of the arm. During the following months past the incident the injury has healed, however, the torn muscle fibers are obviously still missing.
I have consulted two doctors (general practice) regarding the issue and I've had an MR, my primary doctor told me "this looks fine" and that "you will probably have near full restoration of the use of your arm given a year or so".
Despite the option of surgery never being offered I opted for it, however both doctors replied surgery was out of the question.
So I waited, now, one year and three months have passed since the accident. Upon muscle application I can feel a distinct somatic pain like a pinch across where the remaining muscle is. The muscle has almost no strength at all, attempting to use the muscle hurts or at best feel uncomfortable -- depending upon the force applied.
I can feel the muscle contracting without moving anything but the muscle itself, obviously because most of it is torn, and I can also observe a visual difference when I inspect myself in the mirror, when using the muscle there is created a lump/bump in my breast/chest which is not present on the other side of my chest.
This is not a problem at all in everyday conditions, using the arm for trivial, regular tasks is not a problem.
However, my interests include martial arts and climbing, which both put enormous stress on the arms, i.a. having my arm put in an "armbar" during combat, or using my arm to arrest a fall during climbing.
Because of this I have not been able to resume my hobbies and interests.
I contacted my primary doctor again (a year or so after the accident), I told him my conditions had not improved, I asked him to contact an orthopedic surgeon and send him my MR images, however the surgeon replied "It is unlikely this is an indication surgery is needed.", and thus my doctor didn't want to proceed. He simply told me my condition was sadly not possible to improve.
I have taken physiotherapy and attempted training exercises at home to improve the use of the muscle, with near no results; seemingly there just isn't enough muscle fibers left to work with.
My question is, what should I do? I feel that merely because "it is unlikely that surgery is needed" (quote from the surgeon) doesn't mean surgery cannot be done. My doctor actually told me surgery *cannot* be performed in a case like this. This seems contradictory to me -- shouldn't the surgeon have stated surgery is not possible if that was the case?
The reason I'm sceptical is that I live in Norway and this is the public free health service, I get the feeling they do not want to perform expensive surgery unless it is strictly needed, I feel that unless I convince my doctor this is important to me, then he will deny the surgery because he thinks this is a trivial problem.
Would it do me any good to take this to a private clinic?
If it is at all possible I want this issue resolved, I cannot resume my interests and the damage even affects my strength when I execute movements which do not primarily rely on the pectolaris major.
Questions I'm very curious about are among others, where can I find information about muscle surgery? In which cases is muscle surgery possible? How is the procedure performed? What are the risks, if any? What kind of surgeons can perform a procedure of this kind? After a muscle has been torn, is there a time limit for how long after the accident the surgery can be performed?
Sorry for the length of the post and the amount of detail.
Thanks in advance!
Regards,
Christian
Answer Dear Christian,
It saddens me when our doctors seem to tell us to just give up...I like you, feel that until I have exhausted all means I will continue to try to find solutions to the problem.
If I were you I'd write to a sports orthopedic specialist. They are the doctors that have different ideas for unusual circumstances. I am not sure if they'd know what to do in your case but they might have suggestions.
Search for the best you can find...and another tip is if the doctor you find says he can't help you ask him who else he thinks you should look-up.
