Hard to laugh

Here is a funny story, well it will be funny if everything turns out OK. 

When I went to see the Orthopedic surgeon, Dr. Ogilvie, a few days after I broke my foot he didn’t really seem to care that running was actually a priority for me.  In fact, he pretty much just told me to stay off it and come back in five weeks for X-rays.  I had to ask him some more questions and I explained my situation that recovery is pretty important for me as an elite runner.  He didn’t even mention that pinning (getting a screw put into the bone) was often the way to go when an athlete gets a Jones fracture.  I thought at least he would of said, “this type of injury often requires inserting a pin, but in your case you don’t need one because…”

So I told my sports Doc in Guelph that Dr. Ogilvie told me to non-weight bear for 6 weeks and didn’t say anything about pinning.  I also said I was a little concerned he didn’t look at my injury from an athletic point of view.  My sports doc said that Dr. Ogilvie is very highly regarded and that is who she would of recommended seeing anyways.

I also told Dr. Stewart in Hamilton who looked over my X-rays that I was seeing Dr. Ogilvie and he said “that’s who you want to see.”

A few days ago I was emailing the National team doctor and physiotherapist.  I told them my story and who my doctor was.  The national team doc said that if Dr. Ogilvie said that I don’t need pinning than he trusts his judgement.  And then he said something like, “you are talking about Dr. Ogilvie-Harris, right?”

I looked up this Dr. Ogilvie-Harris and saw that this hyphened version was in fact the foot guru.

I emailed Dr. Stewart and told him that there happens to be a great foot specialist named Dr. Ogilvie-Harris in the GTA.  Dr. Stewart replied to me that he assumed I was talking about Dr. Ogilvie-Harris this whole time!  Well shit son, even a Doc from Hamilton thought I was seeing Dr. Ogilvie-Harris in Toronto.

Then I emailed my sports Doc and told her that the National team Doc and Dr. Stewart both thought I was talking about Dr. Ogilvie-Harris and I just wanted to make sure you know I’m seeing Dr. Ogilvie.  She emails me back saying that she too thought I was seeing Dr. Ogilvie-Harris!!

So now it makes sense why everyone was saying that Dr. Ogilvie was the man, because all three were talking about Dr. Ogilvie-Harris.  What are the chances that two orthopedic surgeons within 45 minutes…

Since all the Docs I’ve been confering with really respect the opinion of Dr. Ogilvie-Harris I now would like his opinion on my broken foot.  So as funny as this story might be, I won’t be laughing if I find out in a couple of days that I actually need a pin that I should of had inserted two weeks ago.

Here is a Journal article about Jones fractures, the other Journal articles I’ve seen have similar results:

First published on May 11, 2005, doi:10.1177/0363546504272262
This version was published on July 1, 2005

The American Journal of Sports Medicine 33:970-975 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Early Screw Fixation Versus Casting in the Treatment of Acute Jones Fractures

Timothy S. Mologne, MD^*, Jeffrey M. Lundeen, MD, Mark F. Clapper, MD and Thomas J. O’Brien, MD

From the Department of Orthopedic Surgery, Naval Medical Center, San Diego, California

^* Address correspondence to Timothy S. Mologne, MD, Sports Medicine Center, 277 Altenhofen Drive, Appleton, WI 54913 (e-mail: drmologne@thesportsmedcenter.com ).

Background: There is considerable variability in the literature concerning the optimal treatment of acute Jones fractures.

Hypothesis: Early surgical fixation of acute Jones fractures will result in shorter times to union and return to athletics compared with cast treatment.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Methods: Eighteen patients were randomized to cast treatment, and 19 patients were randomized to screw fixation. Success of treatment and the times to union and return to sports were calculated for each patient.

Results: Mean follow-up was 25.3 months (range, 15–42 months). Eight of 18 (44%) in the cast group were considered treatment failures: 5 nonunions, 1 delayed union, and 2 refractures. One of 19 patients in the surgery group was considered a treatment failure. For the surgery group, the median times to union and return to sports were 7.5 and 8.0 weeks, respectively. For the cast group, the median times were 14.5 and 15.0 weeks, respectively. The Mann-Whitney test showed a statistically significant difference between the groups in both parameters, with P < 001.

Conclusion: There is a high incidence (44%) of failure after cast treatment of acute Jones fractures. Early screw fixation results in quicker times to union and return to sports compared with cast treatment.