NEED THE CAST IF THERE'S A SCREW IN PLACE?

After a recent motorcycle accident, I sustained an injury to my lower leg and ankle. A screw is now securing the lower leg bones as they heal, and I’m required to wear a cast for six weeks. Why is the cast necessary when there’s already a screw in place?

The lower leg comprises two bones: the tibia and fibula, connected by a fibrous sheath known as the syndesmosis. This structure maintains the bones’ alignment while permitting the necessary movement for normal ankle function.

The screw fixation keeps the bones stable and immobile during the healing process. Without a cast, putting weight on the leg could potentially loosen or break the screw.

Doctors pay particular attention to patients who are overweight or have brittle bones, as these conditions heighten the risk of screw failure. Research is underway in Ireland to explore a new method involving a flexible plastic suture material held in place by buttons on the leg bones. This technique might allow for earlier weight-bearing and cast removal if proven safe in studies.

Brian Thornes, FRCSI, et al. “Suture-Button Syndesmosis Fixation.” Clinical Orthopaedics and Related Research, February 2005, Vol. 431, pp. 207-212.