man in hospital bed

Bruce, infection, humerus fracture

Consultant: Mr Ali Noorani

Shoulder and elbow fractures

Bruce’s infection has completely cleared up following careful monitoring by Mr Ali Noorani

Bruce sought treatment with Mr Ali Noorani for an infection following a humerus fracture

Bruce snapped his humerus, the long bone in the upper arm, when falling from a chair. He attended A&E and was admitted to hospital, where he had an operation to fix the bone using metalwork. Four weeks later he was diagnosed with sepsis. Bruce was taking immunosuppressants, which reduce inflammation but lower the immune system’s resistance, and was therefore more vulnerable to infection. Following his sepsis diagnosis, he chose to go to The Wellington Hospital where he was introduced to Mr Ali Noorani, who, because his vast experience and expertise, was recommended as the best surgical consultant to treat Bruce’s condition.

Following an X-ray, Mr Noorani decided to keep the original metalwork in place, because the fracture appeared to knitting together well. Bruce was prescribed antibiotics and taken off his immunosuppressants. He spent four days in intensive care and a further week in hospital, to ensure the infection cleared up before being discharged. Mr Noorani carefully monitored his care every step of the way and Bruce said that he: “felt in extremely safe hands”.

Four weeks after his treatment with Mr Noorani, Bruce was feeling so much better and his arm was 95% healed, aided by a course of physiotherapy.

He added: “I am so glad I was Mr Noorani was recommended to me. Throughout my care he was very approachable, caring, extremely knowledgeable and delivered a high standard of care along with his team. He did a fantastic job and is everything you would hope to find in a doctor. I called him after I was discharged from hospital and he was always happy to help and advise me. I can’t thank him enough.”

Mr Noorani said: “Bruce has done well and his humerus has now fully healed and he has recommenced his immunosuppressants with no negative side effects. He has normal function in his day-to-day activities and has a full range of motion in his shoulder and elbow.”

He continues: “His case demonstrates a few important points. Firstly infection risk is fairly high in somebody who is immunosuppressed and it is therefore very important that the initial surgery is done with meticulous care by an experienced team.

Secondly decision making on what to do after the area becomes infected is also important. Removing the metalwork before the fracture heals is sometimes necessary but also a disaster as it leaves a unstable arm. We carried out several test to confirm that infection was superficial with no deep collections and kept it suppressed with antibiotics until the fracture healed.

In orthopaedics good decision making is important. This case demonstrates that sometimes even without surgery as long as you make the right decisions that patients can have optimal results.”

January 2020