Bruising and Scabbing Over Steel Plate: Should I Remove It?

Bruising and scabbing on the steel plate?

Eight months ago, a steel plate was implanted at the distal end of the left clavicle.
Six months ago, a second surgery was performed due to displacement.
Two months ago, a bruise appeared at the end of the steel plate, and recently, the bruise has started to scab over, with some slight skin cracking.
Doctor, do I need surgery to remove the steel plate? If removal is necessary, is it appropriate to operate on the same wound three times?

wun, 20~29 year old female. Ask Date: 2016/11/04

Dr. Shi Guozheng reply Orthopedics

After the skin has裂開, if there are no signs of infection, then it is sufficient to properly manage the wound.
The steel plate does not necessarily need to be removed; however, if removal is required, surgery can still be performed on the same wound.

Reply Date: 2016/11/04

More Info

When it comes to the management of complications related to an implanted steel plate, such as bruising and scabbing, it is essential to evaluate the situation carefully. Based on your description, it appears that you have had a steel plate implanted in your left distal clavicle eight months ago, followed by a second surgery six months ago due to displacement. Recently, you have developed a bruise at the end of the plate, which has started to scab, and there is some mild skin cracking.

First and foremost, it is important to understand that bruising can occur for various reasons, including trauma, pressure, or irritation from the plate itself. The presence of scabbing and skin cracking raises concerns about potential infection or irritation, which could lead to further complications if not addressed promptly.

In general, the decision to remove an implant like a steel plate depends on several factors:
1. Symptoms: If you are experiencing pain, swelling, or any signs of infection (such as redness, warmth, or discharge), these are significant indicators that the plate may need to be removed. The presence of a bruise and scabbing could suggest that the skin is compromised, which may increase the risk of infection.

2. Imaging Studies: It may be beneficial to obtain imaging studies, such as X-rays or CT scans, to assess the position of the plate and surrounding tissues. This can help determine if the plate is causing any mechanical issues or if there is any underlying bone or soft tissue problem.

3. Consultation with a Specialist: It is crucial to consult with an orthopedic surgeon who specializes in this area. They can provide a thorough evaluation and recommend the best course of action based on your specific situation.

4. Timing of Surgery: If the decision is made to remove the plate, the timing and approach to the surgery are important considerations. Performing the surgery through the same incision may be feasible, but it depends on the condition of the surrounding tissue and the extent of any complications. Repeated surgeries on the same site can lead to increased scarring and complications, so careful planning is necessary.

5. Postoperative Care: If the plate is removed, postoperative care will be essential to ensure proper healing and to monitor for any signs of infection or complications. Follow-up appointments will be necessary to assess the recovery process.

In summary, based on your symptoms of bruising and scabbing over the steel plate, it would be prudent to seek a consultation with your orthopedic surgeon. They can evaluate the need for removal of the plate based on your clinical presentation and any imaging studies. If removal is indicated, they will discuss the best surgical approach and the potential risks and benefits involved. It is essential to address these concerns promptly to prevent further complications and ensure a smooth recovery.

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