Pain and Discomfort from Wrist Implant Surgery: Your Questions Answered

I would like to ask the director a question regarding the issue of internal fixation implants (wrist). Thank you very much?

Hello, Director Shi.
I recently suffered a fall that resulted in a distal radioulnar joint dislocation.
I underwent surgery at a certain hospital where a joint button reconstruction was performed.
However, the doctors did not provide a clear explanation, and it seems they are unaware of the underlying issues.
I am reaching out for clarification because my left wrist's distal radioulnar joint has an implanted device that secures the ulnar and radial bones (a permanent internal fixation device) near the area where I wear my watch.
Both sides of the distal radioulnar joint have internal fixation buttons.

Since the surgery, I have been experiencing swelling and pain on the radial side, while the ulnar side does not seem to be affected (possibly due to a lack of soft tissue on that side).
I had blood tests done, and they indicated no metal implant rejection, yet I still experience pain in the small area where the internal fixation is located.
I would like to ask if it is common for patients with implanted internal fixation devices to experience pain at the site of the implant, such as a foreign body sensation or discomfort.

Additionally, I have been feeling discomfort for quite some time, with tenderness visible on the skin surface due to the protrusion of the metal implant.
Can I request the physician to remove the implant or adjust its position? I apologize for the complexity of my questions, and I appreciate your assistance.
Thank you, Director.

Shu Wei, 20~29 year old female. Ask Date: 2016/10/22

Dr. Shi Guozheng reply Orthopedics

If there is an implant near the wrist, there will definitely be a sensation of tightness.
Once the appropriate time has passed, the fixation device can be removed.
Of course, you should consult your physician for clarification.
Make sure to take the opportunity to ask your doctor during your appointment for a clearer understanding.

Reply Date: 2016/10/22

More Info

After undergoing wrist implant surgery due to a fall that caused a distal radioulnar joint dislocation, it's understandable to have concerns about pain and discomfort in the area where the implant is located. Your experience of having persistent pain and a sense of discomfort, particularly around the area where the metal fixation is placed, is not uncommon among patients who have undergone similar procedures.

Firstly, it is important to recognize that the presence of internal fixation devices, such as screws or plates, can lead to sensations of discomfort or pain. This is often due to several factors, including the body’s reaction to the foreign material, the surgical trauma itself, and the healing process. While your blood tests indicate that there is no metal allergy or rejection, it is still possible to experience pain due to the mechanical nature of the implant and its interaction with surrounding tissues.

In clinical practice, it is not unusual for patients with internal fixation devices to report discomfort or pain at the site of the implant. This can manifest as a feeling of tightness, pressure, or even sharp pain, especially during movement or when pressure is applied to the area. The sensation of the implant being "foreign" or "sticking out" is also a common complaint, particularly if the device is located near the skin surface, as in your case.

The pain you are experiencing could be attributed to several factors:
1. Surgical Trauma: The surgery itself can cause inflammation and irritation of the surrounding tissues, which may take time to resolve.

2. Soft Tissue Reaction: The body may react to the presence of the metal implant, leading to localized inflammation or discomfort.

3. Mechanical Issues: If the implant is positioned in a way that it interferes with normal wrist movement or if there is excessive pressure on the surrounding tissues, this can lead to pain.

4. Scar Tissue Formation: Post-surgical scar tissue can also contribute to discomfort, especially if it adheres to the implant or surrounding structures.

Regarding your question about the possibility of requesting the removal or repositioning of the implant, this is certainly a valid concern. If the pain is significant and affecting your quality of life, it is important to communicate this to your orthopedic surgeon. They can evaluate the situation through physical examination and possibly imaging studies to determine if the implant is indeed the source of your discomfort. If the implant is causing persistent pain and is deemed to be the cause of your symptoms, your surgeon may discuss options for removal or adjustment.

It is crucial to have an open dialogue with your healthcare provider about your symptoms. You should feel empowered to express your concerns and ask questions about your treatment options. If you feel that your current surgeon is not adequately addressing your concerns, seeking a second opinion from another orthopedic specialist may also be beneficial.

In summary, experiencing pain and discomfort after wrist implant surgery is not uncommon, and it can arise from various factors related to the surgery and the implant itself. It is essential to discuss your symptoms with your surgeon to explore potential solutions, including the possibility of implant removal or repositioning if necessary. Your comfort and recovery should be the priority, and effective communication with your healthcare team is key to achieving that.

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