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nonunion of 5th metatarsal screw to be removed

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  #1  
Old 17th March 2011, 11:50 AM
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Default nonunion of 5th metatarsal screw to be removed

Hi, i'm new to this. I feel off a 2ft stage in 2007 and injured my left foot. 2 Xrays at 2 different hospitals show no fracture, so WB. In July 08 after CT & MRI scan they figured it was broken at 4th & 5th Meta was in a light cast for 6 weeks - no healing visible. In Oct 09 had a pin put in. Now in March 11 still nonunion and foot specialist (new) wants to remove screw at the end of month. What is the next stage has he has only mentioned an MRI scan after removal. I'm currently using a heavy walking boot as he said my calf muscle is too tight and I have lost 30% of my movement. He has suggested that I won't have to stay in hospital overnight. (which is good). I can't seem to find any information regarding removing screws before full union. I was under the care of the head of the Ortho department (due to earlier misdiagnosis), but he is a spine specialist and fully booked with spine surgery, so unable to do my surgery within the allocated time. Thus the foot specialist, X-rays from the top gives the impression on full union, but X-rays from the side and bottom show nonunion. I'd be grateful for any advice or help.
based in UK
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Old 17th March 2011, 01:45 PM
Smokey
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Default Re: nonunion of 5th metatarsal screw to be removed

Before I'd let anyone near my foot to remove screws that may or may not be holding it together, esp. if such screws are not causing me pain by being there, I'd be asking all these questions to my surgeon?

You need to ask:
1) Why are the screws being removed if the fracture is not healed? People go through life with screws in their 5th mets without having them removed.
2) Once (or if) the screws are removed, what happens next? The bone is not fully healed. Is it healed enough to support weight?

I agree that being in a walking boot or cast for so long is NOT good for your calf muscles, but you can do exercises (non weight bearing) to help.

But mostly I'd be asking all these questions to the surgeon and getting answers you feel comfortable with before I'd let him come near me with a knife.
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Old 22nd March 2011, 07:23 AM
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Default Re: nonunion of 5th metatarsal screw to be removed

Thanks for your reply. I should have asked more questions. I don't think I'll have an opportunity now, until the morning of the surgery. I am still in a lot of pain, which has eased somewhat with the boot. I'm just anxious about the next stage and can't seem to find anything about what to expect after the surgery.
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Old 22nd March 2011, 07:42 AM
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Default Re: nonunion of 5th metatarsal screw to be removed

I would phone for an appointment to ask those questions before the morning of the surgery! It's your body!

Has an MRI been done? I'm wondering if you have tendon damage as well? Or are there other reasons you haven't mentioned which link the pin/screw to your pain? I am assuming a lisfranc injury has been ruled out already since you're seeing top-rated people.
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Old 24th March 2011, 07:36 PM
everei everei is offline
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Default Re: nonunion of 5th metatarsal screw to be removed

first time on i have a question for anyone, i feel and broke my fifth metatarsel, it was in the shaft, had screw but in with difficulty and they also put in washer, xray showed its healed but still had alot of pain referred me to a specialist in omaha in which did total reconstruction of foot removed screw and washer, relocated nerves from scare from surgery and also took wedge out of heal so i would walk differantly on that foot also walked my shoes over to the out side of my right foot since then i have had several weeks of pt and remain having tingleing and foot pain, hurts if i set in on spot to long, or walk on it to far, had an emg and its showed where he removed nerve and replaced it up higher behind ankle, but that is it, doctor called today and said he could do more explore surgery in that area, around that nerve site, is there anything else that can be done or has anyone had this problem
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Old 30th March 2011, 04:08 PM
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Default Re: nonunion of 5th metatarsal screw to be removed

Hi, I took your advice and called the hospital. Unfortunately the Specialist was in clinic all day, but has said that he will speak to me on the morning of the schedule surgery. No I have not had a recent MRI scan, it is scheduled for after the surgery. A bone scan done in 2008 indicated that arthritis had developed within the fractured joint, but that has not contributed to the constant pain that I am in. The original surgeon said that the 5th metatarsal had quickly deteriorated and as far as I am aware only secured that with a pin leaving the 4th metatarsal. I have kept nothing back.
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Old 13th April 2011, 01:27 AM
pippy
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Default Re: nonunion of 5th metatarsal screw to be removed

Hi

I had the surgery to extract the screw on the 31st March. On the morning of the op, I managed to speak with the surgeon who said that the recent X-rays showed a healed fracture site. Although there is a gap (not sure where) it is not of concern (to him) as it provides flexibility to my range of movements. The surgery lasted for approximately an hour and as far as I know was successful. My foot was dressed and bandaged, I was given a support shoe and crutches; and sent on my way home with some pain killers. The pain from putting pressure on my foot was unbearable.

12 days on and the stitches have been removed. The bandages had to be re-dressed part way through. My foot is a little swollen and sore in a few places. I am awaiting the follow up appointment with the consultant to confirm the next stage in the healing process.

Thank you for your input.
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