Bob Hofman coached the Fort Lewis College Skyhawks to numerous basketball titles during his tenure, but a surgery to ease his pain kept him from shooting hoops for decades.
Hofman lost all the flexibility in his right wrist after he had bones in his arm and wrist fused in the late 1990s. At the time, he was told a fusion was the only way to treat his pain from arthritis, which was the result of a broken wrist bone that didn’t heal properly.
“If you shook my hand, I would go to the ground,” he said.
Hofman’s arthritis was likely caused by a broken scaphoid, one of the eight carpal bones in the wrist, and a notoriously difficult bone to treat because of its low blood flow, said Dr. Brian Butzen, the orthopedic surgeon at Animas Surgical Hospital who un-fused Hofman’s wrist. Butzen specializes in shoulder, elbow, wrist and hand injuries and conditions.
The fusion surgery turned Hofman’s wrist joint into a solid mass of bone that included the end of his radius, an arm bone, and seven of his wrist bones. A metal plate was implanted from his arm to a bone in his hand as part of the fusion.
Hofman doesn’t remember how he broke his wrist, but he deeply regretted the fusion surgery for years as a coach.
Hofman, 67, started coaching in 1974 and retired from FLC after 20 years with the school. His first stint with the college was from 1983 to 1987, and the second was from 2000 to 2016. During his time at FLC, his teams won three regular season conference titles, four Rocky Mountain Athletic Conference Tournament championships, six RMAC West Division titles and appeared in the NCAA Division II playoffs seven times.
The wrist fusion surgery forced him to live and coach differently.
“I had to learn how to fake everything and use my left hand,” he said.
He recalled feeling like a toddler because he couldn’t dribble the ball or shoot. He couldn’t bend his wrist at all in any direction, making the necessary wrist flick for a basketball shot impossible.
The lack of mobility in his wrist forced him to rely heavily on his shoulder and distorted his motion on the right side of his body. For example, he had to rely on his shoulder to screw in a light bulb, he said.
He asked about 10 doctors for a solution and researched his problem online, but without success, he said.
Butzen was treating Hofman’s shoulder about two years ago for a rotator cuff injury among other problems when the two started discussing Hofman’s wrist.
“I would do anything to not to have this wrist fused,” Hofman recalled telling Butzen.
The restored flexibility Hofman was asking for required Butzen to take the fused wrist apart and put in a new joint, made of plastic and metal. Butzen had never done such a procedure, and he hasn’t done one since, although he regularly replaces wrists. He researched the procedure for several months before the surgery and talked with Hofman extensively about the potential risks.
In order to put in a new joint, Butzen had to take out a rectangular chunk of bone just below where Hofman’s radius previously ended, Butzen said.
Radius bones are normally hard on the end, but that wasn’t the case for Hofman’s bone because of the fusion. So when Butzen implanted the new joint into the end of Hofman’s radius, he packed some additional bone from the chunk he removed in the arm to add density, he said.
Hofman has not had normal wrist flexibility since high school, so it is difficult for him to say how the new joint compares to flexibility in an average person. But the new joint has allowed him to do normal tasks, such as holding the handlebar on his bike and unscrewing the cap on the stem of a car tire, he said.
A new wrist joint typically provides about 50 percent of a normal wrist range of motion, Butzen said. Hofman has a little more motion than is typical, but he has been working hard on it, he said.
“The surgery went just like clockwork,” Butzen said.
One of the biggest risks Hofman faced was the implant coming loose, and if that happened, Butzen would likely have had to re-fuse Hofman’s wrist, Butzen said.
Hofman said he would “do anything” to regain his wrist motion. But if his commitment to the surgery had been anything less, it would likely have been too risky, Butzen said.
The doctor said he advised Hofman to avoid high-impact activities that could loosen the implant, such as riding a mountain bike or splitting wood by hand.
The wrist fusion Hofman had is a common treatment for arthritis, especially for younger patients who are not good candidates for wrist-replacement surgery, Butzen said.
The replacement surgery is best for those who are living a less-demanding lifestyle, he said. For example, mountain biking, manual labor or falling during adventure sports are too much for people with wrist replacements, he said.
Hofman said he has had to relearn how to use his wrist and strengthen it, but he is pleased with the results. His new flexibility could allow him to get back into golf, a sport he excelled in as a kid.
“To me, it’s a miracle,” he said of the surgery.
Hofman still considers himself a jock and works out every day. But after more than 10 surgeries, including two knee replacements, because of his active lifestyle, he has a lighthearted view of his own physical condition.
“People I don’t know say, ‘You’re the bionic man.’ No, I’m Mr. Potato Head, ” he said.