Tomorrow, our 12-year-old will have surgery to pin her ankle from a fracture at the end of the leg bone. The surgeon wants to use screws that will dissolve. This will save us a second surgery to remove the screws. This sounds like a good idea. How long does it take for this to happen? Are there any problems that can occur?

Fractures at the distal tibia (ankle) in children pose a special challenge. This is especially true if the fracture goes through the epiphysis (growth plate) or separates the growth plate from the joint. Surgery to hold it all together while it heals may be needed. Metal screws are often used that can be removed later.

But transepiphyseal metal implants (through the growth plate) change the way the ankle is loaded during weight-bearing (standing and walking). Over time, the increased pressure leads to breakdown of the joint. Pain and disability can be the final outcome.

One way to avoid this problem is to use bioabsorbable screws. These implants serve the same function as metal screws: to maintain a closed position of the fracture while the bone heals. But the screws dissolve and are absorbed by the body over the next two to four years.

Several studies report success with this approach. The screws go through the growth plate, but they don’t go across the growth plate. In this way, growth is not disrupted. The long-term tissue response to these bioabsorbable implants is under investigation.

So far, only animal studies have been done. But there have been no signs of reactive inflammation and no obvious problems. The implant slowly dissolves over a period of time (usually months to years). Bone fills in the spot where the implant was located. Sometimes fibrous tissue forms as well.

There’s no reason to believe further problems will develop over time. In fact, the use of bioabsorbable screws is expected to reduce the risk of degenerative joint problems that can occur with metal screws.