WAG Do we take out the screw or leave it in

[momof5]

I am hoping that someone with a lot more gymnastics experience can help me out with this. DD had a 5th metatarsal avulsion fracture last fall and it failed to heal after 8 weeks so she had surgery and they inserted a screw. It finally healed. The Doctor know wants us to consider taking it out. He said that if it doesn't bother her that it doesn't matter if we take it out or leave it in. Well she has only been on impact for 3 weeks after 3 1/2 months on crutches and 3 weeks in walking boot so it is going to take awhile to build up the muscles to try harder landings and more advanced tumbling. She has been jumping and doing front and back tucks and none of that bothers her screw. The only thing that bothers her is when it gets touched on the head of the screw. Doctor said if she wasn't an active kids than he would just leave it in but wants us to consider taking it out since she is a gymnast but wasn't 100% sure it need to come out. Does anybody with more gymnastics knowledge know if more impact and hard landings in the future will affect this. If it doesn't hurt now could it hurt down the road. She is a 13 year old level 9 and wants to do college gymnastics so I see many more years of this. If she takes the screw out she will be off impact again for a couple of weeks. The Doctor says the longer we wait to take it out the harder and more complicated the surgery could be because of calcification around the screw. We could wait for a few more months and see if the harder landings hurt but at the same time she has another injury right now and so she can't do much anyway so if she has to be off impact for a few weeks she might as well do it right now. Any thoughts as to the long term impact of leaving the screw in?

 

[Dr Maleficent]

If I were you I would try to contact an orthopedic surgeon with experience working with gymnasts- this sounds like a highly specialist question and a difficult decision and you ideally need someone who treats lots of gymnasts to answer. Could USAG maybe suggest someone? or one of the coaches on here who has had contact with orthopedists who treat gymnasts?

 

[mariposa]

If it were my child, I'd take it out now. I have no experience with it, but feel that with younger ones, if hardware can come out, it should. Hope someone with more experience chimes in. Maybe @dunno will see the thread.

 

[rjb123]

My DD has hardware in her arm and she has an ortho who has a lot of experience with gymnasts. He said that a lot of times because of the impact that they have, hardware can move and be a lot harder to remove and can cause some issues if left in. In her case we plan on removing her rods in around six more months and from what he said her down time will be VERY short (1 week, plus 1 week of no "aggressive" vaulting/tumbling) If it were to move surgery could end up being more complex with a longer down time. I would think that this could translate to the foot as well. Good luck with your decision.

 

[LizzieLac]

Probably a very different scenario for us. DD has a rod in her tibia - surgery was done to avoid full leg cast for 6-8 weeks, followed by patellar cast for another 6-8 weeks. She is a freshman in HS and unlikely to do college gymnastics. Our orthopedic surgeon's plan was to leave it in until she was done competing (3.5 years). He has done this for numerous soccer players with great success. My understanding is that this is only possible if the athlete's growth plates are closed.

 

[gymdog]

Don't have a lot of experience with this particular injury being fixed with a screw(navicular fractures yes) but I would lean toward having it removed. It seems like the area on top of the bone where the screw is fixed can become more likely to fracture on impact. I think you should get a second opinion, definitely, but it does seem like there are some good reasons to remove it now. There are also some risks, but it seems like those problems are more common with arm bones or rods, and may be less of a concern with the placement of this screw. So investigating with another medical professional seems in order.

 

[Deleted member 14190]

Begs the question,,,, why leave it in?

 

[momof5]

Well all this information helped us make a decision. Thanks guys. I called today to schedule it.

 

[Granny Smith]

My dd had a Jones' fracture back when she was in 8th grade, you didn't say Jones, so I am assuming you were more fortunate with a pseudo-Jones. Dr. had it heal naturally, which literally took 4 months. Dr. strongly suggested not getting surgery or a screw put in. She said for basketball players & soccer players who have Jones' fracture, they have the support of a shoe. For gymnasts, they are a bare foot sport and that indeed the screw would of start to bother them at some point. For us, it was never a decision we had to make, but in your position, I'd seriously consider it, but would consult another doctor for their opinion. My dd is now doing college gymnastics, so having the fracture heal naturally has had no affect on her ability to do gymnastics, long term, 5+ years later.

She now has been dealing with a NSF (navicular stress fracture) that she has had since her junior year of HS (yes, you are reading that correctly, 2+ yrs now). We, I say we but more like she, has decided not to have surgery and has been healing it naturally as well as using a bone stimulator. We had talked to surgeon about NSF surgery and she said that she would use a headless screw, if we went that route. I think my dd is planning to live on the bone stimulator through college and if problems still exist, then go the surgery route. The bone stimulator is definitely aiding in the healing process but it is the most painfully slow process EVER!