Fifteen years ago I slid into second base a bit too late and broke my left fibula and crushed my left ankle. I was really, really lucky I didn't blow out my knee, too. It was during the state softball tournament (FAST PITCH, slow pitch is for sissies) and we were playing our rival team. I was safe.Yay! Until I lifted my leg off the bag to see if the bone I HEARD BREAK was breaking through my skin. DEAR GOD.
Clear as day, as if the words were typed in the air in front of my face, I thought:
"If there is blood on my sock then I know it is a compound fracture and I will pass out."
There wasn't any blood or broken skin, but there was a really, really grotesque bump where the bone was sticking out. *GAG* Anyway, the second baseman tagged me out when I lifted up my leg for a better look. Bitch. I was so furious I elbowed her below the knee, brought her down and started crawling after her, ready to kick her ass. I used to be rather -- spunky. The umpire, a kid who was probably 17 years old, didn't have the slightest idea what to do with me.
The fractures were enough that I had to have surgery. Surgery, based on what the doctor I saw last week said, that was "major" and "traumatic." I was too young (17) and oblivious to really have thought all of that through. Good thing. The surgeon told me I could leave the hardware in there unless it started to bother me.
***Well, it's been bugging me.
So, last week I went to an orthopedic center 60 miles away to have an orthopedic surgeon with an ankle specialty take a look. One of the screws had migrated out a bit (but not through the skin!) a few years ago and I've been worried it would keep going, break the skin (DEAR GOD) or cause infections in the surrounding tissue, plus all sorts of other overly imaginative possibilities inspired in no small part by the X-Files and CSI. Also, I've been getting some tenderness in the area every now and then, especially during and after exercising. I thought it might be time to have all that hardware removed.
The good news is that my ankle recovered from the trauma and surgery 15 years ago like a total champ. I've never had bad arthritis or really any stiffness. The doctor was seriously tickled and said he rarely ever sees anything look this good. Yay! I told him about what activities I am able to participate in, including volleyball, hiking, yoga, fly-fishing in sandals in uneven, rocky streams, etc. and he was really impressed that I have such a pain-free ankle with so much movement. Apparently, I could have been hobbling around, wracked with arthritis. I was pretty ignorant of that possibility. Thank goodness I broke the bones when I was young, healthy and active! So, I am very, very pleased to hear this. And truly, I can't say that my ankle has ever held be back from doing anything I've ever wanted. (Except is is really uncomfortable to wear hiking boots, it really, really sucks to shave over the bump where the screw is *shudder* and to sit in Hero Pose.)
The kind of bad news is - I can decide to have the hardware taken out or not. My decision. The doctor thought there were some good reasons to take it out, including that he could scope around and remove some and something else while he was in there. But he also thought it was a really wonderfully healed ankle and that it is not necessary. This was the worst possible news for someone as indecisive as me.
One of the screws has broken.
Graphic evidence for your viewing pleasure.
I guess this happens all the time to the screws that cross a joint. Anyway - GROSS. So, the head of the screw that broke did indeed move out a bit but most likely is done migrating. HOLY HELL, I sound like I am writing about an alien in me or something. Oh, the nightmares.
There is also some calcium/bone tissue growing around that same screw. This didn't overly concern the doctor, and he didn't think it would turn into an issue down the road. I am having a hard time wrapping my mind around this. It really won't -- say -- fuse to the other bone or grow large enough to start to impede my range of motion? This area (and the fact that the screw that has migrated rubs on my hiking boots and HURTS A LOT and totally grosses me out) leads me toward considering surgery.
I am young enough that supposedly I am still able to deposit calcium in my bones. Wouldn't it be a good idea to have the hardware removed now, while my bones can heal while adding calcium rather than later, when bone density and strength are a much bigger concern? But - I healed wonderfully from the first surgery. Should I leave well enough alone? Argh. Plus, going under again? Scary.
I have lots of thoughts either way, and of course, have come up with a slew of questions I couldn't think to ask while at the surgeon's office. I have copies of my x-rays, so I think I am going to get a second opinion. If it looks like I should have surgery, I will go back to the OCoR to do it. (Many colleagues and friends have gone there and every last one of them has been very pleased with their care and results.)
(A surgeon friend showed another ortho my x-rays and they agree that just removing that one screw would be best. Leave a well-healed trauma site alone, and all that. Also, they are both wary of scoping if I am not actually having trouble with the ankle. I am really leaning toward this decision, myself, and plan on calling Consulting Surgeon Number One to discuss this.)
Oh, the indecision!!