Post-Fracture Rehabilitation: Concerns After Removing Steel Pins

Q: Post-Fracture Rehabilitation: Concerns After Removing Steel Pins

Hello Amily： Typically, recovery from a comminuted open fracture is slower than that of a regular fracture. <br>However, it has been nearly two months since your injury, and the doctor has removed your bone screws. <br>Therefore, you can carefully walk on your flat foot as long a

Rehabilitation Issues After Removal of Metal Pins from Fractures

Hello Dr.
Lee: On June 26, I suffered a comminuted open fracture of the left fifth metatarsal due to a car accident, and I had four steel pins inserted.
On August 16, an X-ray showed that the bone had healed, and the pins were removed.
The doctor said I could start bearing weight and walking; however, I am not allowed to ride a motorcycle until September 27 (three months post-injury).
I would like to ask Dr.
Lee: On August 6, I returned for a follow-up and had my cast removed, but at that time, the bone had not yet healed.
Therefore, I returned on August 16 to confirm that the pins could be removed.
On August 6, the doctor mentioned that I could start bearing weight no earlier than September 27, but on August 16, after seeing that my bone had healed, he said I could bear weight.
Can I really trust that I can safely bear weight and walk now? I am still experiencing swelling and pain (especially in the afternoon), and whenever I start walking, it swells and hurts shortly after.
Additionally, I feel a tingling and thick sensation when I touch the injured area.
I am very afraid that if I bear weight, the bone will fracture again, so I am only using a single crutch to assist my left foot and only walk for a short distance.
So, can I really start to safely use both feet for rehabilitation and walking? Thank you.

amily, 30~39 year old female. Ask Date: 2017/08/19

Dr. Li Yongheng reply Orthopedics

Hello Amily: Typically, recovery from a comminuted open fracture is slower than that of a regular fracture.
However, it has been nearly two months since your injury, and the doctor has removed your bone screws.
Therefore, you can carefully walk on your flat foot as long as you avoid falling or twisting it; there should be no major issues.
Additionally, please remember to return for an X-ray three months after the fracture.
Wishing you a speedy recovery.

Reply Date: 2017/08/19

More Info

Hello! Thank you for your detailed inquiry regarding your post-fracture rehabilitation after the removal of steel pins. It’s understandable to have concerns about your recovery, especially after a significant injury like a comminuted open fracture of the fifth metatarsal. Let’s address your questions and provide some additional context regarding your situation.

Firstly, it’s great to hear that your X-ray on August 16 showed that the bone has healed sufficiently for the removal of the steel pins. In general, once a doctor confirms that the bone has healed, it is typically safe to begin weight-bearing activities. However, the timeline for resuming full activities can vary significantly based on individual healing rates, the extent of the injury, and any underlying conditions such as osteoporosis or circulation issues.

Regarding your concern about whether you can safely start putting weight on your foot, it’s important to listen to your body. If you are experiencing swelling and pain, particularly after walking, this could indicate that your foot is still in the process of healing. Swelling can be a normal part of the recovery process, especially in the early stages after surgery or pin removal. However, persistent or increasing pain, especially if it is severe, should be evaluated by your physician.
The “numbness” and “thick” feeling you describe could be related to several factors, including soft tissue healing, nerve irritation, or even residual swelling. It’s not uncommon for patients to experience these sensations as the body adjusts post-surgery. However, if these symptoms worsen or do not improve, it would be prudent to consult your healthcare provider.

As for your fear of re-injuring the bone, it’s valid to be cautious. The healing process can take time, and while the bone may be structurally sound enough to bear weight, the surrounding soft tissues (muscles, ligaments, and tendons) may still be recovering. It’s advisable to gradually increase your activity level. Start with short distances and use your crutches as needed, gradually transitioning to full weight-bearing as tolerated.
Physical therapy can be incredibly beneficial during this phase. A physical therapist can guide you through exercises that promote strength and flexibility while ensuring that you do not overexert yourself. They can also help you develop a safe walking pattern to minimize the risk of falls or further injury.

In summary, while your doctor has indicated that you can begin to bear weight on your foot, it’s essential to proceed with caution. Monitor your symptoms closely, and do not hesitate to reach out to your healthcare provider if you have concerns about pain, swelling, or any new symptoms. Your recovery is a process, and it’s important to give your body the time it needs to heal fully.
Wishing you a smooth and speedy recovery!

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