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Broken Ankles and Growth Plates
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Little Mint suffered a nasty break on Saturday. He had broken his ankle and the growth plate had moved. They had to operate to get everything back in place and have inserted a screw.
There was talk of the danger of his leg not growing properly but they hoped they had avoided this with the operation. However, they warned he must not put any weight on that leg for the next 5 weeks.
After four nights of little or no sleep in the hospital and a lot of stress and strain I made the decision to self discharge Little Mint today. I just couldn't bear to spend another night there. I took the view that he isn't ill as such. They were just concerned about him getting around at home. I decided to take that risk. Getting into the house was really difficult but once we were in, I thought we'd be fine. He's got a zimmer frame and crutches but in actual fact the crutches are a lot more difficult to use than you would imagine. That will take a little while for him to get good at but he's reasonably okay on the zimmer frame, he can sleep downstairs and there's a toilet downstairs.
He just got up on his zimmer frame and forgot himself and put the bad leg down. He's now in agony because of it. I got him back to the sofa and he's resting but he's terrified that his leg won't grow now. The break shifted the growth plate and they put the screw in it put it back in place but they did warn that if he put weight on it, it could affect his growth.
Whoops!
Does anyone know whether this one incident of putting weight on his leg is going to have done too much damage?
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Comments
I did discuss it with the physio. She said that she was unable to give us the all clear because of getting up and downstairs. I talked to her about getting him into the house and surviving just using the ground floor and she agreed that he would be okay with that. It's just going to take time for him to get used to using the crutches and yes, that was the purpose of staying in hospital. However, we were on the top floor and so to practice stairs he would have to start off by going down them which is the most difficult.
It was like being in solitary confinement in there. The physio visited for 20 mins each morning and that was all the attention he was getting. She wasn't dead set against us going home (I wouldn't have done it otherwise), just unable to confirm his ability to go up and downstairs which he doesn't need to do for the time being.
He could just have easily put that weight on his leg in the hospital as at home.
Minty - JP jr (15yrs old) has broken his hip twice last year (on the growth plate- the muscles around the hip being tto strong for the bone causing it to snap) and then broke his leg last weekend playing rugby. He is not allowed to weight bear atall and is having bone density scans next week.
The consultant told him not to weight bear and if he did he would not do it again, due to the pain, they did not mention anything about growth problems
As Nam suggests it may be worth going back for an opinion, or even more painkillers etc of he has problems and expalin to them his concerns
Minty
I self discharged my child from hospital once .......chill. Bin the guilt.
Mine was far worse. Sick child. Lumbar puncture suggested and in foreign lands........... I knew the blood results did not suggest meningitis and could see M was recovering from her sunstroke (yes it gets worse - am truely a bad mother) and we left. Dr was happy and realised I knew what I was doing. If you take a child to hosp they are obliged to offer everything and be cautious. Sometimes common sense wins over that but won't stand up in court (hosp has to avoid litigation )
You made a sensible decision as a mother and with physio discussion. I f they had really thought it a bad idea they would have made that clear
This may make him more motivated to be truely immobile which is what the leg needs to allow the growth plate to heal and blood supply to do it's thing
Good luck
I realise I sound like a terrible mother in these posts............
That's just what I wanted to hear Mrs Pig. Thanks. I was beginning to feel like a really bad Mum but honestly, it wasn't doing either of us any good him being in there. He bought the nurses a box of chocs but told me that if they didn't let him go home we were going to sit and scoff the lot! We were both in tears this morning out of sheer frustration. The ward is full of very poorly children and I just felt we were in the way. I felt guilty asking for pain killers, sheets, anything - they work so hard and flat out and I just felt we were complete nuisances because he isn't exactly ill.
They made me sign away any rights of litigation. I'm not the litigious type tbh - unless there's negligence - and there certainly wasn't that (unless of course your looking at my culpability).
JP - it did cross my mind that this will be on the one and only time that he puts weight on it, now that he knows just how painful it is.
Little Mint wishes his break had been caused by a game of rugby - he said that would give more street cred. A roller blading accident doesnt carry the same cudos for some reason.
I've sent you a nice long mail
A review and x-ray will presumably be planned fairly soon ?
Mrs Pig, we should compare notes some time. I swear you can't be as bad as me. When I went into hospital to have him, I took one nappy and a cuddly toy for him! PMSL
When Little Mint was in hospital two years ago with suspected appendicitis, a nurse said he didn't have it because he looked too comfortable. Whilst he was fast asleep I decided to give a big prod and when he didn't wake up, I rang the school and said he was in hospital but hadn't got appendicitis and would be in later.
When I got back to the bed, the surgeon was there. She confirmed he definitely did have appendicitis and arranged to take him down to theatre as a matter of urgency.
Whoops!
Oh dear.
Alarm bells ringing.
Hope Little Mint issoon mended, Minty
Plaster is off. I'm pleased because you hear of so many people having to stay in plaster for much longer. Mind, we did take them at their word and he's only twice accidentally put weight on the leg.
I was gutted to hear that they want to remove the screw which means another stay in hospital and a six week recovery period - in about six months' time.
No physiotherapy!! I'm stunned at that because he's walking like a cripple. I guess it will get better in time. Fingers crossed.
He's got a great PE teacher (who believes Little Mint shows real promise in rugby and reckons he's turned out players for England who started out just like LM). He's going to give him walking exercises to do to build up his strength which I said we'd carry on at home.
Once he's fit enough (don't know how long that's likely to be though), I intend to get him out running with me again.
Thanks kittenkat. I think my major concern now is (a) how long will it take for him to walk properly? Surgeon said he can have the crutches for just two weeks yet he can't manage at all without them, and (b) shouldn't he be having physio?
It may well be that walking is such a natural thing which he's bound to do on a daily basis and so he will self treat in terms of physiotherapy. I'm not going to argue with the experts but I didn't receive much of an explanation.
Again, if the surgeon says to take out the pin, then that's what we'll do but I'm just dreading him being out of action again - it's been murder!
Cheers kittenkat.
Good news. Little Mint had the screw removed on Tuesday. The operation was a success and he's walking better without the screw than he was with it. He needs a few weeks to recover and then we can start regaining his levels of fitness. He was overweight before the accident but very active. The inactivity has caused him to put on more weight so we've got our work cut out.
That's funny -I was thinking about you and wondering how he was getting on
I'm glad he's on the mend. Now please don't boing this thread again (reminding everyone of my appalling maternal abilities......tsk)
Great news that little Mint is on the mend
Broken ankles are no fun!
Thanks Beebs, Mrs Pig and Broken Bones.
Mrs Pig, I thought I'd provided you with some comfort with my own tales of mismanaged maternal skills! I don't get any better either.
<jumps up and down in excitement> Thanks joddly and yes please.
His foot is still slightly turned outwards. There doesn't appear to be any prospect of physio and perhaps it doesn't matter. My main concern is having him fit enough to go back to playing full contact rugby in September. We were told no contact sport now for 2-4 weeks but Little Mint feels he can walk perfectly well (even without the crutches he's been advised to use) and even says he's okay to run ... although I'm not encouraging that just yet. We were told to wait at least 2 weeks before he can cycle but he feels he's okay to do that now (five days on from operation). When is it okay and when is it not okay - should pain be the barometer or should we wait for the all clear from the surgeons?
Hi - I need a bit more information, but generally speaking, if it feels OK then it is OK.
How old is Little Mint, and can you be as specific as possible about the fracture "pattern" and in which direction the screw went?
Growth plate injuries usually heal quickly. The screw would have been to hold the fragments together while this took place, and would only be removed if the surgeons were happy that the fracture was united. IAny further wait would probably simply be to allow the wound to heal up properly.
You can email me if you'd prefer patient confidentiality
!
Thanks joddly.
Little Mint is 12. It was a 'salter harris' (sp?) type fracture and a few other technical terms which I can no longer remember. All I remember is that they wanted to manipulate the ankle and the growth plate under general anaesthetic but when they got him into theatre it was worse than they thought and so they opened him up and screwed him back together. Sorry I don't know which direction the screw went. Possibly upwards given the scar was low down on his ankle. Any more than that I just don't know.
Collected my post this evening (we have a mail box and I regularly forget to check it). The letter was there with his two week follow up appointment for this Friday (which is actually only a week and a half).
He doesn't feel the need for the crutches but the surgeon did say that he wanted him to use them as a reminder to himself and others that his ankle is a bit delicate for the time being - he suggested two weeks. Less than a week after the operation, I'm struggling to persuade him to use them.
Like most kids, Little Mint tends to bounce back very quickly. Apparently he was the quickest kid ever to eat again after having his appendix out. I think it was less than three hours after the operation!
Salter Harris III would make sense. At this stage, if the wound is healing well there should be no need to rest it as long as he feels fine, so don't worry that he's not using crutches.
At 12, as you know, there is a small risk of growth arrest. It is only a small risk if the fracture has been put back ("reduced") anatomically (ie perfectly aligned) and has healed, which sounds as if is the case. Signs of growth arrest may be evident at this stage (?4months) as incomplete or sloping Harris lines (also called growth arrest lines) which they can show you (or rather, the normal complete ones, I hope) when you're in clinic on Friday. You can probably Google that for a bit more info.
Good Luck.