12 year old son had a 5mm avulsion fracture in July of last year. Due to separation distance, he had to have surgery and 1 screw was placed. He had no problems in rehab and throwing program. His first game this weekend, it was raining and cold and he felt pain/discomfort. He was throwing from SS and 3rd. No pitching.
After visit to surgeon, he explained that is was the head of the screw rubbing...with the cold weather probably making it worse.
Has anyone experienced this? Does it go away? Will it only happen in cold/raining weather? I will give him some Advil beforehand and ice afterward, but any other suggestions? Will OTC lidocaine spray help? He will be doing some additional stretching excercises daily.
The surgeon assured us he is not injured and just needs to work through discomfort.
Post by Drew Parker, MD on Feb 25, 2017 16:16:24 GMT -6
I'm going to take a little leap and assume that he had a displaced medial epicondyle fracture of his elbow that was treated with surgery. I'm glad to hear that the throwing program went through without a hitch. It's a common enough complaint to have pain with implants with colder weather. I don't think anyone has completely nailed down the reason why, although one school of thought is that it's the temperature change causing the metal to expand/contract relative to what the bones are doing since your native tissue is able to regulate its own temperature in a way that screws cannot. Sometimes this particular fracture is treated with a screw with a washer associated with it, which can certainly cause more "rubbing".
To answer your questions directly: He is experiencing a common complaint that does not necessarily indicate any larger problem. Often it goes away with warmer weather or just with a greater amount of time for the body to get used to the screw. A protective sleeve over the elbow may keep it warmer and thus mitigate some of the reason for the pain. If the screw hasn't caused any problems prior to throwing in cold weather, then that may be all it takes to fix it. OTC lidocaine spray may help, but just trying to keep the elbow warmer might be a simpler solution. In some cases, the screw may remain symptomatic even when it warms up outside. If that is the case - and the fracture has sufficiently healed, it is a relatively straightforward surgery to remove the screw.