Femur Screw Removal?

[Arrods]

OH fractured femur 2+ years ago and has healed well. Sudden pain getting to bottom of stairs. X-Ray suggests a screw just above knee has loosened. Appointment awaited to see specialist. Anyone had any experience/comments if the solution is to remove the screw? OH is very worried given all the other health issues she has suffered. Many thanks.

[Buenchico]

It's good to know that I'm not the only one with a screw loose around here ;-)

If you'd prefer a more serious answer though, take a look at this thread:
http://www.vitalmx.com/forums/Moto-Related,20/Femur-screw-removal,1277708

[Arrods]

Thanks Buenchico. Most of the stories (apart from one surgeon's mishap) in the link seem comforting, especially the example very similar to OH's situation. NB Screw-loose jokes are now banned in this household!

[Sqad]

The fracture has healed well and your OH is not in pain, then the surgeon is almost certain to leave well alone.

However, depending upon the age of your OH and depending upon the degree of pain and the condition of the hip on X-Ray, he may remove the pin and plate and perform hip replacement.

But, from what you have said...........he/she will leave well alone.

[Arrods]

Now you have got me worried Sqad. OH, who's 65, otherwise fit and with no osteophorosis has always had a degree of pain since her accident. She jarred her knee 4 weeks ago when she reached the bottom of the stairs since which time the pain has been very bad when negotiating stairs. Strangely walking along seems fairly OK. In fact I'm beginning to wonder if her regular gym exercise regime has caused the problem in the first place.

I earnestly hope removal of the plate and screws is not the solution (apparently this involves more complex surgery than when they were first installed) let alone a hip replacement.

[Sqad]

OK...well, this will now depend on the condition of the hip as judged by an X-Ray. If the hip joint shows signs of Osteo-Arthritis, then the surgeon may decide to remove all the "hardware" and perform a hip replacement.

It all depends on the condition of the hip as shown on X-Ray.

[Arrods]

Sorry to prolong this Sqad, but I don't understand the connection between OH's injury and her hip. She doesn't have any 'hip' issues at the moment. Are you hinting that the injury can in some way affect the hip?

[Sqad]

I am assuming that she had a fractured neck of femur and that she had a pin and plate to stabilise the fracture.

The hip may or may not have been osteo-arthritic before the fracture, but the injury exacerbated the condition of the hip.
So yes, there may well be a connection and it is this that will help the orthopaedic surgeon to decide what is to be done.
Not an easy decision in a fir 65 year old,

[Peter Pedant]

erm sqad - you re doing your clinic too fast ..... sloooooooow down

The screw is above the knee - [ and I have never seen a neck of femur go that low ] and if it is loose and causing pain then the surgeon may opt to advise removal

Arrods OH hasnt seen the consultant yet and so no assessment has been done - for a start he may agree that the pain is not related to the screw


I am not persuaded that it is that big a deal to be honest - removing a screw but it depends on what was done in the first place - like is the screw stabilising a fracture across the joint and so on

I think you have to wait and see Arrods
and then perhaps repost

you are second guessing when we dont really know what the first guess is

[Sqad]

PP....I have made it clear how my reply is posted on the basis of the available evidence.

That is the best that anybody can do.

[SirOracle]

Which university did you obtain your medical degree from PP. ?

[Peter Pedant]

Sir orac Cambridge since you ask

[Arrods]

Thanks Sqad and Peterp. I do of course appreciate that this is all speculation until OH sees the consultant. This all arose from a visit to the GP this a.m. to hear the X-Ray results and the suggestion that it 'could' be due to the loosening screw. I was just curious to know what the procedure was if it was 'simply' a question of removing the screw. So, we hope for the best, fear for the worst and take what comes. I'll keep you posted.

[SirOracle]

Thank you PP.

[Arrods]

Just thought I'd let you know that OH had the screw removed without problem (plus some knee arthroscopy at the same time) and she was home the same day. It all went very well in the end.