Post-Surgery Complications: Persistent Hematoma After Clavicle Fracture Repair

Five days after clavicle fracture surgery, there is serosanguinous drainage from the wound?

A 20-year-old male sustained a comminuted fracture of the clavicle due to a motorcycle accident.
He underwent surgery with a self-paid titanium clavicle plate.
Five days post-operation, the wound continued to exhibit serosanguinous drainage (bruising).
Since it was outside of regular clinic hours, he went to the emergency department, where the physician was unable to determine the cause and simply changed the dressing.
The following day, he experienced further drainage, prompting him to seek outpatient care.
The outpatient physician, who was not the operating surgeon, also could not provide an explanation.
As the operating surgeon's clinic appointment is not available for another three days, he is seeking advice from Dr.
Shi in the meantime.

Li Lao Han, 40~49 year old female. Ask Date: 2016/10/22

Dr. Shi Guozheng reply Orthopedics

If there is bruising coming from the wound, it is necessary to change the dressing and keep it clean to prevent infection.
Typically, the wound will heal within seven to fourteen days.

Reply Date: 2016/10/22

More Info

Post-surgery complications, particularly persistent hematoma after a clavicle fracture repair, can be concerning for both patients and their families. In your case, the 20-year-old patient suffered a comminuted clavicle fracture due to a motorcycle accident and underwent surgery with a titanium plate. The presence of ongoing drainage or bleeding from the surgical site five days post-operation raises several important considerations.

Firstly, it is essential to understand that some degree of swelling and bruising (hematoma) is common after surgical procedures, especially in cases involving fractures. The body’s natural healing process can lead to the accumulation of blood and fluid in the area surrounding the surgical site. However, persistent bleeding or significant swelling beyond the expected timeframe may indicate complications such as a hematoma that is not resolving as it should.

In your situation, the fact that the patient experienced ongoing drainage and bruising after five days suggests that there may be a few potential causes:
1. Infection: One of the most common complications following surgery is an infection at the surgical site. Signs of infection may include increased redness, warmth, swelling, and discharge that may be purulent. If an infection is present, it can lead to increased bleeding and delayed healing.

2. Hematoma Formation: A hematoma can form if blood vessels are damaged during surgery, leading to localized bleeding. If the hematoma is large enough, it may require drainage to alleviate pressure and promote healing.

3. Surgical Technique: Sometimes, the surgical technique itself can contribute to complications. If the fracture fragments were not adequately stabilized or if there was excessive tension on the soft tissues, it could lead to complications.

4. Patient Factors: Individual patient factors, such as blood clotting disorders or the use of anticoagulant medications, can also contribute to persistent bleeding.

Given that the emergency physician and the outpatient physician were unable to provide a definitive explanation for the ongoing bleeding, it is crucial to follow up with the surgeon who performed the procedure. The surgeon will have the most comprehensive understanding of the surgical technique used and the specific circumstances of the case. It is advisable to keep the follow-up appointment and discuss the symptoms in detail, including the duration and characteristics of the drainage.

In the meantime, the patient should monitor for any signs of infection, such as fever, increased pain, or changes in the appearance of the wound. If any of these symptoms arise, it is important to seek medical attention promptly.

In terms of management, if the hematoma is significant and causing discomfort or complications, the surgeon may consider performing a procedure to drain the hematoma. This can relieve pressure and allow for better healing. Additionally, ensuring that the patient is following post-operative care instructions, including keeping the area clean and dry, can help prevent complications.

In conclusion, while some degree of swelling and bruising is normal after clavicle fracture repair, persistent bleeding should be evaluated by the surgical team. It is essential to communicate openly with the healthcare providers and ensure that the patient receives appropriate follow-up care to address any complications that may arise.

Similar Q&A

Understanding Recurrent Infections After Clavicle Fracture Surgery

Hello Doctor: My boyfriend had a clavicle fracture and underwent surgery after a car accident. The doctor recommended using out-of-pocket materials. About a week after the surgery (during the transfer from the intensive care unit to a regular ward), we noticed continuous bleeding...

Dr. Li Wenlin reply Orthopedics
Wounds from car accidents are more susceptible to infection. You can schedule an appointment with the physician through the nursing station to discuss your condition and also inquire about any concerns you may have regarding medical supplies.

Post-Fracture Joint Issues: Understanding Complications After Surgery

1. The occasional numbness and burning sensation in the ankle, foot, and toe joints two months after the fracture surgery may be due to nerve irritation or compression, possibly related to swelling or scar tissue formation. 2. The discoloration and mild swelling of the affected ...

Dr. Shi Guozheng reply Orthopedics
After a lower limb fracture and surgery, it is normal for swelling to persist if blood circulation has not yet returned, which may take more than three months to recover. For a clavicle fracture, do not elevate the arm as it may cause the metal pins to shift. It is normal to feel...

Complications After Clavicle Surgery: What to Do When Pins Fail?

Hello, I would like to ask a question. My friend had clavicle screws inserted a year ago (or opted for better screws at their own expense). After the surgery, they were only given a sling for support, without a figure-eight bandage. They have been returning for regular check-ups,...

Dr. Shi Guozheng reply Orthopedics
After the fixation of a fracture, there may be instances where, after a period of time, the removal of the bone screws can lead to a re-fracture, which may require another surgical procedure for improvement.

Managing Exposed Artificial Ligaments After Shoulder Surgery: Key Concerns

Hello Doctor: Last November, I suffered a distal clavicle fracture-dislocation of my left shoulder, along with ligament injuries. After undergoing surgery with self-funded artificial ligaments and two titanium screws for fixation, everything healed well. However, in March of this...

Dr. Shi Guozheng reply Orthopedics
If there is no discharge from the wound, it is unlikely to be infected. Blood tests can determine the presence of infection. Inflammation may occur before an infection develops, making healing more difficult. Debridement may improve healing, but after removal, further evaluation ...