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  • NeedHelp
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    Post count: 5

    Greetings,
    I am new to this forum but have been observing it a lot ever since my spinal cord injury that just took place about a month ago. I sustained two gun shots 1 to my Arm and 1 to my back, while getting shot the force or maybe the shock since it was a close distance shooting led me to fall face first on the pavement thus fracturing the cervical part of the spinal cord (Neck). The CT scan of the neck showed a comminuted fracture of the posterior right C4 facet, in addition there are hairline fractures of the right lamina C5 and Comminuted fractures of the spinous processes of C7 to T3. I was given a Aspen Collar and told to keep it on for 6 weeks, i have now had it on for 4, at the start of my injury i had a lot of burning sensation and pain in my hand and several muscle cramps that would make my hand so stiff and it only goes away when i wiggle my fingers then it feels as if a little rush of blood or something runs through the hand making it less tense until it happens again very shortly, this pain seems unbearable at some points. The pain had reduced a little bit as the weeks went by but i could still feel it even while i was on percocets (pain killers) i cant use my hand as i could before this being my right hand (my dominant hand)and me being a top prospect in the country for basketball has me feeling very distraught and sad, i just wonder if my hand will ever go back to being normal and functioning fully as it once did? I am supposed to go for a MRI test sometime this week for the right bracheal plexus to show what was damaged inside. Im also wondering why this pain is so strong in my hand and why it hasnt really gone away even after a month, keep in mind i also had a clot in the auxillery vein however the ultrasound showed that the blood was flowing so they okay’d it. Im 19 years old and just extremely worried as a normal human would, what can i do to reduce the pain? I also wonder will my neck be able to turn side to side as i once did or will the turning be reduced slightly? Also my shoulder doesn’t seem to rotate fully as much as my left shoulder does but im assuming that also stems from the injury to the spine or maybe the discomfort of the aspen collar on my shoulders or neck muscles. Your help is greatly appreciated, and any input is very beneficial.

    Thanks for reading.

    NeedHelp
    Member
    Post count: 5

    Some 1 please help…

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    A gunshot wound can cause multiple injuries to the spine and surrounding nerves. The entrance and exit wounds are important to note as this defines the damage tract of the bullet. If you have right hand symptoms and the bullet passed near the spine causing fractures and exited near the shoulder, both the cervical nerve root and the brachial plexus could have been injured.

    After four weeks, an EMG/NCV test by a neurologist can shed light on the damaged nerves. This test however will not necessarily lead to better recovery but at least can lead to a better prognosis. You need to undergo intensive therapy on the hand for the working nerve roots to compensate for any damage. Some of the damaged nerves can recover (see “nerve injury and recovery” on the website for a better understanding).

    In regards to cervical range of motion, you should not be testing your neck for this motion now. You have fractures of a facet and lamina as well as spinous processes. These fractures take time to heal. You would not try walking on a broken leg until the bone had healed. The same goes for neck fractures. Give these fractures at least eight weeks to heal before you start range of motion.

    Dr. Corenman

    NeedHelp
    Member
    Post count: 5

    Dr. Corenman post=4286 wrote: A gunshot wound can cause multiple injuries to the spine and surrounding nerves. The entrance and exit wounds are important to note as this defines the damage tract of the bullet. If you have right hand symptoms and the bullet passed near the spine causing fractures and exited near the shoulder, both the cervical nerve root and the brachial plexus could have been injured.

    After four weeks, an EMG/NCV test by a neurologist can shed light on the damaged nerves. This test however will not necessarily lead to better recovery but at least can lead to a better prognosis. You need to undergo intensive therapy on the hand for the working nerve roots to compensate for any damage. Some of the damaged nerves can recover (see “nerve injury and recovery” on the website for a better understanding).

    In regards to cervical range of motion, you should not be testing your neck for this motion now. You have fractures of a facet and lamina as well as spinous processes. These fractures take time to heal. You would not try walking on a broken leg until the bone had healed. The same goes for neck fractures. Give these fractures at least eight weeks to heal before you start range of motion.

    Dr. Corenman

    The entrance wound was through the bicep exiting out the arm pit, and the second entrance was in the back close by the spine but it did not touch the spine or any spinal columns. The fracture in my neck happened from falling face first on the cement ground after the impact of the bullet thus making me land on my neck in a awkward way causing the nerve damage. As for the damages you said i shouldnt try moving my neck until 8 weeks but im only supposed to keep the aspen collar on for 6 does that mean i should still keep it on for the extra 2 weeks to be on the safe side? Thanks alot for your help it is deeply appreciated and although the truth may hurt sometimes it brings closure and a little rest mentally. As for the spasms and cramps in the hand do you know what i can do to ease this pain?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Cervical fractures can take between six and twelve weeks for healing. The time variability depends upon the structure damaged, the comminution (fragmentation) and the stability of the structure injured. Without knowing the specific extent of the injury, I can only guess about how long it would take to heal. Your trauma surgeon will know that information.

    Regarding the pain in the hand, this could be from injury to the nerve root or more likely, the brachial plexus. It will take time to heal. There are medications like Gabapentin (Neurontin) that can help with the symptoms while the nerve is healing. Again, ask your trauma surgeon if you are a candidate for this medication.

    Dr. Corenman

    NeedHelp
    Member
    Post count: 5

    Hello Doctor Corenman,

    Its been 2 months and 3 weeks since i have last posted and your insight and opinions on my injury are still deeply appreciated. I have released my aspen collar for a while now and have regained almost full function and range of motion in the neck still a little soreness in the central part of my neck whenever i turn my neck fully to the right not so much on the left. I was wondering if this would be a life long type of sore/stiffness or as time proceeds and more movement is made it should vanish? Also my gunshot wound to the brachial plexus has still been the major problem as my hand has regained some function as to moving my fingers, wrist and arm as it is gaining more strength but i have developed contractures in my palms which have my fingers curled for the most part unless i lay the back of my hand(knuckles facing the ground) on a stable surface i get some support and manage to make it as straight as i can even though its not as straight as my left hand is. How can i get my fingers to extend fully and manage to close my fist fully, im almost there but it seems i just dont have enough power to clench the fist i stop some where almost or at the middle of my palm. Also i feel like my joints have stiffen up as my fingers are still a little swollen and stiff, how can i get full function of my hand back? Lastly, my muscles around the biceps shrunk completely but now that times progressed i can flex it and the lump has been formed i would love to make it bigger but i cant grip anything enough to work out or develop it again. The tightness of the bicep i believe has also developed an elbow contracture as i have started physiotherapy it seems to be getting better but i still cant extend my arm fully from the elbow it just feels like i cant stretch out that arm or the bicep gets really tight and burns. Please look this over and get back to me, once again deeply appreciated for your expertise and hope to hear from you soon. Thank you!

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