Jones Fracture Surgery Question

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
***************************************************
It is unclear to me from your post as to whether your doctor's concerns were predicated upon the possibility of splintering of the proximal fracture segment or, as it appears you seem to have taken it, on failure of the hardware. Medical treatment always requires decisions and judgments, but I think it unlikely that an orthopedist would routinely decline to employ bone screws in the course of fracture treatment.

 

My doctor said "I don't want to put a screw in and risk the tip breaking off and being sued for malpractice without trying a conservative approach". My issues are I am a firefighter and worry about possible reinjury and running out of paid sick time. I will bring all of this up with him on Friday, but wanted to see if screw failures were common. Thanks!

 

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
***********************************************
It is certainly within the standards of practice to use screw fixation in a Jones fracture, and so, if a screw is used appropriately and well placed, there is really no case for a malpractice suit even if it should break, though I have personally never had a screw used in a surgical fixation of a Jones fracture break. But that doesn't mean it can't happen. I certainly cannot interject my judgment for that of your doctor, as I have not examined you, but if, in fact, a screw were deemed the better choice and it was not used and a non-union took place . . . THEN I could see the prospects of litigation. Now, I'm not suggesting that a screw fixation would be the better course in YOUR INDIVIDUAL CASE, but why not ask him if he EVER uses a screw for internal fixation without first attempting a closed correction, and if so, under what circumstances.

 

From my consultation both screws and natural healing were appropriate, but he leans toward conservative approaches for well aligned fractures. I live in a college town and he replied "If you were on the football team, I would place a screw today". I find it hard to argue with a doctor about his reasoning for treatment, but probably did not ask enough questions. I have learned a great amount about Jones fractures since my initial consult. He explained everything appropriately, it is just sometimes hard to digest everything or come up with questions during the first consult.

Thanks for your advice. Although not a college athlete, my work as a firefighter can be physically demanding and I am ready to get back to work. I will take your advice and ask more questions about the screws.

 

Hello there,
Did he give you any time before he would revert to using a screw to fix it ?
Mick

 

No.... No time frame on screw. He just said come back in a month (tomorrow) for repeat x-rays and go from there.

 

Did he give you any indication as when you will be on your feet so to speak ?

Also do you get any pain/discomfort at the fracture site ? (I do )

Mick