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Slowtwitch Forums: Triathlon Forum:
Bone Hardware - Screws and Plates

 

   


m012184

Mar 23, 10 17:14

Post #1 of 21 (6096 views)
Bone Hardware - Screws and Plates Quote | Reply

I am 6 Months out from having a plate and screws put in my ankle. I'm reacting badly to increased activity. Anyone have this stuff taken out? Pros/Cons? Please fill me in!


wkrives

Mar 23, 10 19:43

Post #2 of 21 (6059 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

Most of the time plates and screws stay in. If they start irritating the skin and soft tissue, they can be removed. Obviously if the hardware comes out, the holes will have to heal, which can take some time. They do make some allograft materials that you can place in the void to promote healing. Look at some bone putty with bone morphogenic protiens (BMP's) like www.isotis.com. Obviously, this is a decision that you'll make with your orthopaedic surgeon.


HongKongButter

Mar 23, 10 19:52

Post #3 of 21 (6057 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had 8 screws/plates in my clavicle, 7 removed one year later but last one remained b/c it was too deep and removal would have been somewhat more complex. They were removed because I couldn't carry anything on that shoulder and you could even make out the screw heads on a number of them. The only limitation after removal was to avoid showering/swimming etc until the incision healed.

The bone will have healed and the process of filling in the cavities left by the screws happens naturally. As your ankle bears more weight you might have to stay off it for a while but nothing like the original recovery.


m012184

Mar 23, 10 20:20

Post #4 of 21 (6036 views)
Re: Bone Hardware - Screws and Plates [HongKongButter] [In reply to] Quote | Reply

I'm just barely back to a few miles of slow running and have significant localized swelling at the top of the Plate. It seems to occur regardless of activity. I am going back in a boot for 2 weeks to see what pans out per Doc's orders today.

Not psyched about surgery, but not sure about symptoms of rejection. I am looking for the long term fix, I did a lot of long stuff before and want back into it, but am not in a rush. Was there a magic number for time to keep these in? I've heard one year. Anyone still have theirs in after getting back to high activity levels?


birchfinch

Mar 23, 10 20:52

Post #5 of 21 (6025 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I just had a single screw in my 5th metatarsal for 4 months. My screw was put in almost immediately after the break (in September '09). I was hobbling significantly anytime I wore anything on my foot.

Once it came out (in January), it was a mere two weeks until I was at 85% normal. This last 15% has been a slower return to normal than I'd like, but it is definitely improving.

So, I can't speak for anyone else, but for me, getting screwed was great. But take it out when you're done.


m012184

Mar 23, 10 21:12

Post #6 of 21 (6017 views)
Re: Bone Hardware - Screws and Plates [birchfinch] [In reply to] Quote | Reply

well said, thanks!


maxbrain

Mar 23, 10 21:49

Post #7 of 21 (6010 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

You can get the hardware yanked and then the holes plugged up with DBM (demineralized bone matrix). you will heal up pretty well from this especially if platelet rich plasma (prp) is used in closing up after the hardware is out which will just expedite the healing, i mean season is around the corner. Go talk with your orthopedic surgeon about the options though. I'm short on time right now to go into depth, but if you want more info PM me. Good luck, and btw insurance should cover the second op.


gamebofh

Mar 23, 10 21:59

Post #8 of 21 (6007 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

pm rroof and get his opinion.

-Jot


go so slow

Mar 24, 10 5:16

Post #9 of 21 (5977 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had 8 screws and a plate for a broken collar bone. 15 months later I had it pulled out. I didn't want to do it because the 1st surgery was awful, but of course there was a broken bone involved then. The surgery to remove it ended up being pretty close to a non-event. I had surgery on Friday and was back at work on Monday. The recovery was a breeze. If it's bugging you and the doctors say its ready to come out this sample of 1 says get it out.


moots

Mar 24, 10 5:56

Post #10 of 21 (5965 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had a compound fracture of my right elbow , had a plate and four screws put in . This was in 1991 they are still in there no problems for me


NYCTri

Mar 24, 10 5:56

Post #11 of 21 (5963 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had an OATs proceedure on my ankle a few years ago and ever since I wish I had not had it done. They had to use to screws ro reattach my medial malleous. Now that it has healed they have no use and may be rubbing some ligaments causeing pain and swelling. The screws will be coming out in the next few weeks. Accordig to my doc it should not be a huge recovery as long as things look ok inside my ankle. The risk is very minimal and it might clear up my problem. You may be similar. I would give it more time though. My doc wanted to wait a year to make sure it was all healed and strong. Scheduling and jobs have made that year 3 now.

JW (on the comback trail)


Vagabond

Mar 24, 10 6:00

Post #12 of 21 (5960 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had a couple put in my right ankle about 15 years ago and have never really had any huge issues from them. I remember the first several months were difficult but it gets a lot better with time. I have had several injuries to various parts of my right leg and foot that I suppose could be related but I don't know for sure.


------------------------------
Jack


Brian in MA

Mar 24, 10 6:33

Post #13 of 21 (5946 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I've had a plate and six screws in my left clavicle for about 3 1/2 years now, no issues at all with it since. Like others have said, if the tissue around it starts to become irritated then I'll probably have it removed but otherwise it is staying in.



"You can never win or lose if you don't run the race." - Richard Butler



johnpostmd

Mar 24, 10 6:48

Post #14 of 21 (5936 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

While each fracture pattern is unique, generally they fall into certain classes and require certain repair considerations. At 6 months postop, you'd not think the hardware the source of your issue unless, in that rare instance, either the metal is loose or the fracture has yet to heal fully. When you go back to your doc, request an xray to evaluate the the current healing status and hardware position. If all's well, and the surgeon can't find any other explanation, perhaps you're just a slow healer. Unless the hardware is impinging on another structure, it is not likely that it's removal at this stage would improve things.

John H. Post, III, MD
Medical Director, Training Bible Coaching
Contributor, Ironman.com
http://www.johnpostmd.com
Dr. Post's Blog is a medical/injury resource for triathletes.


Rubin

Mar 24, 10 6:51

Post #15 of 21 (5934 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

In Aug 08 I had a Tri Maliolar Fracture and now have my Ankle screwed side to side front to back. I also had the complications of a blood clot . I will tell you physical therapy as much and often as you can afford I would go to a sports or dance oriented therapy as they will push you the hardest. I will be getting mine out after IM St. George as the do bother me and I have not been able to push the run because of the screws and swelling. Good luck I know it seems so long to get back , but I cant believe just over a year removed of learning to walk I am doing a IM . Best of luck The Screwed Club


Rob99

Mar 24, 10 7:41

Post #16 of 21 (5917 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

A family member of mine had a break in his lower leg last year and he got a portable ultrasound device ( not sure if it was from the orthopedist or physical therapist) which apparently was supposed to speed up the healing process. Pretty neat stuff as I am a tech geek, although he implied it was expensive. Perhaps one of our resident slowtwitch docs might comment on these, as I am not sure if he had a plate put in. However, if things aren't healing properly it could be something to investigate. Also, i am pretty sure he was using this soon after the break happened, so not sure if it would be appropriate for your situation. Good luck!


rroof

Mar 24, 10 8:08

Post #17 of 21 (5906 views)
Re: Bone Hardware - Screws and Plates [Rob99] [In reply to] Quote | Reply

resident tech geek here ... ;0

Called the Exogen by J&J. Low frequency ultrasound external bone growth stimulator. Most others use a certain electrical frequency inside a magnetic field.

Should be enough Google info there if you wish ;)

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


KoopaTroopa

Mar 24, 10 8:40

Post #18 of 21 (5895 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I had a tib/fib fracture in 2003 and have a rod in my right tibia with 2 screws in the ankle and one up near the knee. It took me about a year before I could even think about running on it, although the 40lbs I put on subsisting entirely on delivered pizzas and coke while I was laid up certainly didn't help the matter.

I never had it removed, I'm currently training 15-20hrs a week and I forget the stuff is even in there unless I happen to be walking through the metal detector at the airport.


justgeorge

Mar 24, 10 11:37

Post #19 of 21 (5862 views)
Re: Bone Hardware - Screws and Plates [KoopaTroopa] [In reply to] Quote | Reply

damn me too, tib/fib xmas 2002 2 screws in ankle and one near the knee with a 12mm titanium rod from my knee to my ankle. It all stayed in. Ran Chicago marathon 2004, now training for IMW, no problems. Glad I didn't have to take anything out.

I only set off an airport detector once, normally I don't.


sp in az

Mar 24, 10 14:10

Post #20 of 21 (5832 views)
Re: Bone Hardware - Screws and Plates [m012184] [In reply to] Quote | Reply

I was run over by a truck while jogging in 2007. Tib- Fib broken in numerous places and 2 plates with about 16 screws put in to hold it all together. One of them irritated my hamstring tendon so had it taken out, had 6 more weeks of inactivity while that healed. Dr says the other one (longer/ more screws but not near knee) will probably stay "forever".


don't just do something..... sit there


KoopaTroopa

Mar 24, 10 14:22

Post #21 of 21 (5828 views)
Re: Bone Hardware - Screws and Plates [justgeorge] [In reply to] Quote | Reply

In Reply To:
damn me too, tib/fib xmas 2002 2 screws in ankle and one near the knee with a 12mm titanium rod from my knee to my ankle. It all stayed in. Ran Chicago marathon 2004, now training for IMW, no problems. Glad I didn't have to take anything out.

I only set off an airport detector once, normally I don't.


I think I'm about 20% or so total for setting the metal detector off. Most airports I sail right through no problem, but there are a couple where I get pulled aside and frisked 100% of the time. I'm guessing it mainly depends on the make and model of the detector.

   
 
 
 



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