Screws in tibia ORIF

[Calicorizzo]

I had an oblique fracture of the distal third of my left tibia. Fibula also broken. I had an ORIF on 4/21/10 with an intramedullary nail and two screws at the top and three screws at the bottom.  It has been slow to heal which I understand as this is a difficult break. I've lost 70 lbs and become more active. A recent bout with pain and swelling that was not clot or velour Otis caused me to have an X-ray. The transverse screw is apparently too long and you can clearly see where it has dug a divet into the fibula at about the fracture line. My surgeon said he'd take the screw out if the swelling came back. He described the screw as "prominent." I sought a second opinion and that surgeon said all 5 screws were too long, but only the one was causing a problem. The tin and fib Are growing together at the site where the screw is digging into the fibula which is apparently not good. He is going to take the screw out in 2 weeks, but does not guarantee that the pain will improve. My question is, how long should the screw extend beyond the bone? In my case it is one-half to three-fourths of an inch.

[S. Kaul, MD]

Hi there!

Well, there are no definite guidelines about the length of the screws though an orthopedician could choose a length he/ she thinks would be appropriate to provide stability to the fracture depending on the type, location and extent. Even if they went completely through the bone, one would not want them to protrude much beyond the bone. Although it would not be appropriate to judge somebody’s opinion without knowing the details.
Hope this was useful.

Take care!  

[Calicorizzo]

Velour and Otis=cellulitis
Tin and fib=tib and fib
Gotta love auto correct!

[Calicorizzo]

Thanks. You confirmed my suspicions.

[sara_eagle]

In my experience (assisted orthopedic surgeon for 5 yrs) when he performed procedures such as yours, the screw never went completely through the bone.  Best of luck!