Do you think these might be ‘Piffin’ screws?
My son Matt broke his calcaneus (heel bone) in a fall while rock climbing a week ago, and had surgery yesterday to screw the pieces back together. He will be on crutches for at least 6 weeks.
Sorry about the misleading title, I am trying to keep my sense of humor about this.
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It ain’t what you make, it’s what you don’t spend
Replies
Yow.
He's screwed all right.
Greg
this is gonna be interesting...
hope he's okay!!
If we don't bring the troops home,
How we gonna invade the next country that
Pi$$es us off???
(dollar signs have double meaning)
Ugh. Hope he likes weather forecasting; it's likely part of his life now.
Know it's part of mine, and I have no spiral fasteners to show for it, either.
Well, the resolution on those X-rays is pretty poor, but most likely those are one "cancellous" screw and two "cortical" screws. Cancellous screws are designed for purchase in cancellous bone, which is the porous bone tissue on the inside of bones. "Cortical" bone is the dense shell on the outside of the bone. Like Piffin screws (which, if I understand correctly, are just drywall screws), cancellous screws have a smaller core diameter and a larger thread diameter and pitch to try to get a better grip without pulverizing the material they pass through. Cortical screws have a thicker, stronger core and a tighter thread pitch.
Modern bone screws may be made of surgical stainless steel (most common) or titanium (more expensive, modulus of elasticity is closer to that of bone).
They can be fully threaded or partially threaded for use as lag screws; self-tapping or may require the hole to be tapped (virtually all bone screws are pre-drilled); and can be solid or cannulated, so that they can be placed over a thin guide wire that is inserted under fluoroscopic (live X-ray movie) control to minimize damage while the surgeon finds exactly the right place to put it. The intra-operative X-rays show two such guide pins, as well as a couple of "joy stick" pins that are used to manipulate the fragments into position.
There are even special screws that have different pitches, wider near the tip and narrower near the head, so that two pieces of cancellous bone can be joined with compression (lag screws only work if one of the pieces has a good hard cortex on it).
Sorry to hear about your son. From here it looks like they got a good reduction. :)
Rebeccah
Thanks for the information. I have learned a lot with this boy.
He has had other breaks, including one on the growth plate in his wrist about 5 years ago.
He suffered with Osgood-Schlatter's throughout high school.
And now this._______________________________________________________________
It ain't what you make, it's what you don't spend
I wanted to say that I am grateful for the well wishes, as I expect I won't directly respond to all of the posts here.
Matt is doing OK, the post surgurey pain has hit him, and he took some Vicodin just now.
I expect he will have a rough night tonight._______________________________________________________________
It ain't what you make, it's what you don't spend
Piffin screws,..."just" drywall screws?...!!!!!
Snort, they're better'n that!"If 'tis to be,'twil be done by me."
It is because I rail against those who use drywall screws for anything but drywall that they got nicknamed Piffin screws...ANYTHING else IS better!
Welcome to the Taunton University of Knowledge FHB Campus at Breaktime. where ... Excellence is its own reward!
"one "cancellous" screw and two "cortical" screws."Available at McFeely's?BruceT
MATCHING FASTENERS - Head: Oval, Steel, Stainless, Hex (0) Nope.Rebeccah
Trim head stainless steel!
Yep, that's what they look like to me! Heads are too small for Trapeze.
Although for the installed price of those, I bet you could get at least 8 or 10 sets of those steak knives from the Piffin Corporation. (One set knives per order $500. or over.)
Trim head stainless steel!
Trim head Titanium...
only the best for Matt...Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming<!----><!----><!---->
WOW!!! What a Ride!Forget the primal scream, just ROAR!!!
Man that sux. Capn hit it though. He's got a built in barometer now.
I'm wondering if the screws are now there forever or will come out. When I was 15 I busted a knee something good and had multiple screws and 3 long pins in there for about 2 months. Initially, the screws were going to be permanant, but it got infected and by the time they went in to fix that they said the bones had fused good and yanked out the hardware. I dont know what they do now. Kind of hope the metal comes out.
Find the kid a hobby. Sittin on your duff all day sure isnt fun. Good luck to him in the healing process.
Real trucks dont have sparkplugs
Ah, the first three had me confused. They're apparently during the surgery, and you can see forcepts in the first two.
The screws DO look a lot like Piffin screws. Maybe Piffin gets a royalty everytime someone breaks something? (I'm guessing they're stainless-steel and would look a lot like trim screws.)
Now you know why I invest in ATI!;)
Welcome to the Taunton University of Knowledge FHB Campus at Breaktime. where ... Excellence is its own reward!
OUCH!!!
had a friend screw up his ankle while climbing, not as bad though. He had a piece of protection pop,dropped 30+ feet when the rope stretched tight, he bounced of a little ledge 5 feet from the ground, could've been much worse. Hope his recovery goes smoothly.
Also, small consolation, but at least it wasn't a head injury. We were climbing once where the day before, a guy climbing had broke lose a rock causing him to fall. The rock nailed his belayer in the head, killed him. The line was then released and the guy climbing fell 40 feet onto his belayer, probably saved his life but he was arlifted out a real mess. When your son recovers, make sure he always wears his helmet. (while climbing)
Edited 3/27/2007 2:32 pm ET by deskguy
I am trying to keep my sense of humor about this.
Ask the surgeon if he used Festool's special orthopedic model cordless drill/driver. Frankly, I think they are way overpriced and you can't get any discounts and you need to use their proprietary screws and...
--- Ask the surgeon if he used Festool's special orthopedic model cordless drill/driver. Frankly, I think they are way overpriced and you can't get any discounts and you need to use their proprietary screws and... ---Substitute "Synthes" for "Festool" and you're not far wrong...edited to add link:
http://products.synthes.com/prod_support/Product%20Support%20Materials/Charts/SUSA/SUCHTScDrlTapJ1364B.pdfRebeccah
Edited 3/27/2007 7:12 pm by Rebeccah
Thanks Rebeccah,I learn new things every day (and hope I never stop). Your discussion from the x-rays let me know in just a couple of paragraphs about the methods used by the surgeons today for effective reconstruction. Sounds like a lot of "boat in the bottle" work with the guide wires. Thanks
Marc
Most welcome. I get a kick out explaining this stuff. And yes, it is a bit like building a "boat in a bottle", more and more as they go for smaller and smaller incisions to minimize soft-tissue trauma.Rebeccah
I gather from your profile that your in medical related software?I've had a fair amount of interest just lately (see Ouch!!in General). I'm in military related software. Thanks
Marc,I was an orthopaedic surgeon in private practice in central Illinois for 5 years before giving it up to join the software development industry in the SF Bay area. I'm not doing any medical programming, but I sure would like to.Rebeccah
Please send me a note through my profile.
I really think you should look at the EZ guide orthopedic instruments over the Festool. They're less pricey and somewhat more versatile. And besides, bone doesn't know or care what instruments are working on it.
Cool. Are they autoclavable, or do they have to be soaked or gassed?I've been known to use a Black and Decker drill in the OR.Rebeccah
Rebeccah,
If you get back into an OR, you should dump that B&D trash and try a Milwaukee drill.
(Here we go. Hold on.)
Ron
Makita :)
Bosch Bulldog...Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming<!----><!----><!---->
WOW!!! What a Ride!Forget the primal scream, just ROAR!!!
<Are they autoclavable?>
I wanted to keep my fixator and screws and pins; they said I couldn't have the screws "because they are sharp".
Whatever.
They gave me the fixator in a little bag in the recovery room - still warm, from the autoclave, I guess. I keep it here on the desk.
View Image
Forrest
Edited 3/28/2007 7:32 pm by McDesign
"because they are sharp".There are a couple of explanations for that stated reason, neither of which has anything to do with not trusting you to keep a sharp object. Well, there may be some who subscribe to the theory that patients shouldn't be given anything sharp, but it's not the main reason.One explanation is to protect anyone who might have to handle them to get them from the OR to you. Screws and threaded pins can be very difficult to get clean, since stuff tends to stick in the threads. Injury by sharp objects that have been contaminated by human bodily fluids is an everpresent occupational risk for health care workers, one which hospitals are continually trying to reduce. The operating room itself is a controlled environment, with ritualistic behaviors that mitigate the risk somewhat. Once the sharp object leaves the OR, especially when destined for a nonstandard location (like home with you), the control is gone. If they put the pins (which are longer than they look like when they are sticking out of you, and won't fit in the plastic boxes they use for dentures and so forth) in a plastic bag, someone can easily stab him/herself with them, and then there's a whole slew of counselling and testing that have to be done both for the stab-ee and for the patient who was the source of the bodily fluids. It's a big hassle and a liability, and no one wants to deal with it.The second explanation is the operating room nurses have strict requirements about counting "sharps" repeatedly near and after the end of the surgery, to prevent accidentally leaving something behind in the patient. Not something that is likely to happen when removing an external fixator, but it's like putting on a seatbelt -- something that is done every time, whether strictly necessary or not, so that it happens automatically when it is. It takes a concerted effort, timed just right, to interrupt this routine. Everyone can be planning on saving the pins at the start of the case, but when it gets to the end, there may be a different scrub nurse or circulating nurse, or everyone is just in the groove of turning over the room, and it can very easily get forgotten. Because they're sharp, they don't just get thrown in the trash where they can be easily retrieved if someone remembers later. Nor are they going to be saved for return to the manufacturer or donation to some charitable organization that performs orthopaedic surgery in third-world countries, or disposed of in some other idiosyncratic way. No, as soon as the final count is complete, they get put along with the needles and knife blades into a large, rigid plastic "sharps box" with a small opening at the top that is specifically designed to be impossible to stick your hand inside of. Once they've gone into the sharps box, they basically cannot be retrieved. This is most likely the *real* reason why you didn't get your pins.Finally, and this has nothing really to do with their being sharp, OR personnel don't really see much value in the pins, as compared to the fixator itself, which is more exotic and expensive. It can be difficult to persuade the OR staff to invest the time and resources to cleaning and autoclaving them and keeping track of them to get them to you -- the fixator is easier to clean, and easier to conceive of as a "memento" of your treatment and worthy of the effort.Rebeccah
Thanks for that explanation - I've always wondered about that, but I was out for some additional repair, so couldn't question.
Forrest - bitter no longer
Heck,
I broke mine almost three years ago. It hurts still and limits me.
That is supposed to be the hardest bone in the body to break. The surgeon who talked to me from time to time (mostly about how to lay his hardwood floor), told me the range of reponse for a broken calcaneous goes from walking in six weeks to amputation. Depends mainly on what has happened to the subtalar joint the calcaneous sockets into. He described the process of rebuilding that joint as similar to reassembling a broken egg. It's good to hear you son at the good end of the range.
It hurts, man. Wish him well from me.
By the way, I fell three feet.
Be careful.
Ron
Thanks, Ron. I guess as far a heel breaks go, Matt's is definitely on the better end of the spectrum.
The surgeon was very optomistic about a full recovery, in time, of course.
He fell about 6 feet._______________________________________________________________
It ain't what you make, it's what you don't spend
He fell about 6 feet.
Is that right? That much can happen from falling 6 feet?
Can I take it that it was not a strait fall heal first?
I fell 24' and broke my back but man I dont think my back is/was as bad as that heal.
My BIL was an emergency room doc for 30 years and he told me of an incident where a guy was hang-gliding, crash landed, heals first, he said that his heal were drivin right through the foot.
Heres wishing your son a full and speedy recovery.
Doug
Doug,
I broke my heel falling just 30" onto turf. Just happened to land wrong, I guess.
Heck, I hope your son does better than I did and I was back at work the next day, cast walking in 2 weeks and cut the cast off at 5 months.SamT
Anyone who doesn't take truth seriously in small matters cannot be trusted in large ones either. [Einstein] Tks, BossHogg.
Matt's got a soft cast right now, but only until next Tuesday, when that will come off and be replaced by a splint.
The doc said absolutely no weight bearing until he says so, minimum 6 weeks.
The doc seems to think that Matt can be back to normal activity in 12-16 weeks._______________________________________________________________
It ain't what you make, it's what you don't spend
Thanks, Doug. The doc says he sees lots of these injuries from falls of 3-4 feet.
All in the way you land, I guess._______________________________________________________________
It ain't what you make, it's what you don't spend
My heel injury was from a fall of 4-5 feet, onto rock. Climbing shoes provide no padding, also. Not suprising at all that you could break something in that situation. Hope his recovery goes quicker than expected.
When I was about recovered, I jumped off of a counter onto a concrete floor. Bad move. Another month before I could walk normal.zak
"When we build, let us think that we build forever. Let it not be for present delight nor for present use alone." --John Ruskin
"so it goes"
Amazing how easily a person can get hurt. I have never had a broken bone, in 30+ years of construction, and other things like water and snow skiing, motorcycles,etc.
I guess Matt is paying my dues._______________________________________________________________
It ain't what you make, it's what you don't spend
Indeed. That little fracture is the closest I've gotten to a broken bone, and I've done plenty of "risky" things- lots of rock climbing, mountain biking, etc. I prefer not to get hurt though, so I calculate my risks. And I'm lucky. That helps a lot.zak
"When we build, let us think that we build forever. Let it not be for present delight nor for present use alone." --John Ruskin
"so it goes"
A buddy of mine once fell about that 24' and broke his back and a heel! As he was slicing air, he thought, "Plenty of snow piled up down there so this won't hurt much"He didn't know about the 4' tall rock immediately under the surface of the snow piled there
Welcome to the Taunton University of Knowledge FHB Campus at Breaktime. where ... Excellence is its own reward!
"Plenty of snow piled up down there so this won't hurt much"
I had snow too but luckily I didnt have the rock! Although the snow didnt break the fall much - Broken back in 5 places. Wrenched my knee a tad but that was the fartherest thing from my mind. All in all I think I was pretty lucky, could have been much worse!
I wasnt thinking about much on the way down but as I lie there I was thinking that I'd rest for a little while then get back up in the tree and finish the hunt, never went as planned. Lucky to crawl to the truck and get to the hospital. Worst 1 hour drive I ever experienced.
Doug
That is supposed to be the hardest bone in the body to break
No lie. Afloat ortho witchdoctor said it was a sprain; can't break that on a ship, after ship's doc referred to the ortho to confirm the break, which is why the HC plastered it. Had to stump ashore, AMA, to get a real ortho to look at it, and actually confirm a break. Ashore ortho wanted to know who ordered plaster, and why wasn't it immobilized earlier, and just what do you mean, son, you walked here . . . ?
Some weather better than others. Post-insult bursitis only seems to happen every three-four years or so (and if rapid, correct, medical attention had been available, I'd not have that, mostly).Occupational hazard of my occupation not being around (sorry Bubba)
A friend of mine had screws taken out of her broken leg (when it healed) and she showed them to me. They looked identical in every way to a 2 inch wood screw with a Robertson head (square to you southern guys). The head looked the same. The threads looked the same. Because it was silver I can only assume they were stainless. I was expecting something special looking when in effect they "did" something special.
roger
Not all that special, I guess.My Dad had a knee replacement a few years ago and his surgeon described the process as 'basic carpentry'._______________________________________________________________
It ain't what you make, it's what you don't spend
What kind of screws are these?
Expensive, painful screws would be my guess.
The painful we got.
The expensive is coming._______________________________________________________________
It ain't what you make, it's what you don't spend
15 years ago, they would have been something like $35-50 per screw ( plus labor to install) :)Rebeccah
Yeah, the labor will kill ya. :-)_______________________________________________________________
It ain't what you make, it's what you don't spend
I hope those are stainless screws- that heel bone has definitely been pressure treated.
Best wishes to your son. I put a little fracture in my heel bone while rock climbing about 7 years ago. No surgery required, but it hurt like he77 for a while. Real hard to keep climbing with an orthopedic brace on, too.
zak
"When we build, let us think that we build forever. Let it not be for present delight nor for present use alone." --John Ruskin
"so it goes"
want to have fun, go through the metal detector at the court house
looks like pocket hole screws, probably used the kreg jig!
Heck, I've got a kreg jig, I coulda done it!_______________________________________________________________
It ain't what you make, it's what you don't spend
hope he's okay...
airport security might be tuff to get thru now.......
Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming
WOW!!! What a Ride!
Forget the primal scream, just ROAR!!!
airport security might be tuff to get thru now.......
They'll give him a little card with a miniature xray on it to show to security.
Yeah, I thought of that. Would've been better if he had landed on his head, you know how hard that is!_______________________________________________________________
It ain't what you make, it's what you don't spend
That's what I say to my grandson (5 yrs old), "Should have landed on your head; less chance of damage."He's a real hardhead (G)Marc
so much for "I'm bullet proof"......
and yup....
the head woulda been better...
Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming
WOW!!! What a Ride!
Forget the primal scream, just ROAR!!!
I've got a bunch of those in me and IIRC, they're titanium. Hope he's as lucky as I am. 10 years later and I'm no better at weather prediction than I was before.
http://logancustomcopper.com
http://grantlogan.net/
"We have enough youth, how about a fountain of smart?"
I hope you're right about the weather thing. I have to wonder if you and him are a little more prone to being struck by lightning with those screws in there._______________________________________________________________
It ain't what you make, it's what you don't spend
>>>>>>>I have to wonder if you and him are a little more prone to being struck by lightningThat would probably be a good thing. We engineered mutants need a little jolt to push us to the next level.http://logancustomcopper.com
http://grantlogan.net/
"We have enough youth, how about a fountain of smart?"
I can predict weather with my broken knee and also tell time, within five minutes.
>>>I can predict weather with my broken knee and also tell time, within five minutes.
No sense trying to impress the gals if you're around...
_______________________________________________________________
It ain't what you make, it's what you don't spend
LOL, I can tell time closer than five seconds - not with a broken knee but with my wrist.....I used to be able to swing a compass too. Haven't been in the woods with one for a few years tho, so I'm not sure how ferrous I still am. I don't have any implanted metal though. I come by it naturally, like the dowsing.
Welcome to the Taunton University of Knowledge FHB Campus at Breaktime. where ... Excellence is its own reward!
I shot myself through he foot with a framing nailer a while back (through the bone into the ball of my foot from above) and the wound actually healed quite quickly and I was back at work on crutches in about a week and a half but I didn't get physical therapy and it set my gait crooked and that, (two months of limping and favoring the right foot) set up a whole chain of events that lasted for about seven years, with plantar fasciatis in both feet and lower back pain. Make sure your boy gets some good conditioning to balance out his posture and gait as soon as he's back on his feet. It ain't necessarily all better when he can walk on it again.
------------------
"You cannot work hard enough to make up for a sloppy estimate."
Sorry to hear about your seven year odyssey of pain.
That is good advice about getting the proper therapy as he starts walking again. Matt lives at the Olympic training center in Colorado Springs, and has access to some of the best physical trainers in the country, so I'm hopeful they will help him get back to full capacity._______________________________________________________________
It ain't what you make, it's what you don't spend
Glad to hear it. Hope he heals quickly and fully. All the bestMichael------------------
"You cannot work hard enough to make up for a sloppy estimate."
Shelternerd,
Healing is harder and slower if you don't do the right things in the early stages. What are you doing now to get over your injury?
When I was recovering from a fractured calcaneous, I went to physiotherapy, which restored some range of motion in the joint, but the best thing I did was to visit an osteopath. This is a non-medical profession specializing in restoring proper alignment to bones.
In our first, one-hour session, this osteopath pushed, pulled and stuck some neeedles in me. Then, he made one quick hard pull with my foot twisted in a particular way. I felt something shift within my foot and a severe and debilitating pain that I had had for a year was gone. Ended. Never came back. (I'm smiling now remembering that moment.) I limped and dragged myself into his office. I walked out.
I went back three or four more times and each time, he made some radical improvement to the function. If not for his skills and knowledge, I would not have been able to work with my body again. It hurt too much.
Osteopath.
Ron
Just FYI, osteopaths are fully licensed physicians in all 50 states, just like MDs. Their origin, however, was as an alternative to what they and the homeopaths termed "allopathic" medicine. Like chiropractors, they focused their attention on bony malalignment and dysfunction in the musculoskeletal system in general as a source of illness. They had a big fight for legitimacy in California in the 60s. Check out the wikipedia article
http://en.wikipedia.org/wiki/Doctor_of_Osteopathy It's pretty good.Rebeccah
Rebeccah,
It's different here in Canada. The osteopath I went to has never studied medecine. He trained in China as an acupuncturist and then in the US as a massage therapist. The osteopathy, he learned through a course from an American school, partly on site and partly by remote learning.
As far as I know, it is an unregulated profession in Canada. The two that I know (who are both immigrants from the US) are certainly not MD's. However, there may be a lot of MD's who are also osteopaths. I don't know. I do know that the practice worked for me.
And now, I'll go and read the wikipedia piece.
Thanks
Ron
Sorry, didn't realize you hail from Canada. I have no idea how things are there.Sounds like your guy9s) took a course in Osteopathic Manipulative Therapy (OMT).There are undoubtedly some MDs in California who are osteopaths, due to the bizarre legislation that the California Medical Association pushed through in the 60s to allow DO's to become MDs by payment of a $65 fee (they wanted to eliminate the osteopathic profession entirely, and did succeed in eliminating professional licensing for it in California for about a decade). However, the vast majority (here) are not. Taking a course in osteopathing manipulative therapy doesn't make you an oesteopath (in this country) any more than taking a pharmacology course makes you a pharmacist, or taking a course in sports medicine makes you an orthopaedist. Or for that matter, any more than taking a course in chiropractic manipulation makes you a chiropractor. That's a regulated health profession here, too.There's a lot to be said for manipulation by a skilled practitioner for certain conditions. Sounds like yours was one such.Rebeccah