Steel Rod Issues in Orthopedic Recovery: A Patient's Guide

Nail problems

Dear Dr.
Lee,
I would like to ask for your advice regarding my mother.
She was involved in a serious car accident in 2008, resulting in two fractured ribs, a broken left clavicle, and a concussion.
She underwent surgery at that time to have metal pins inserted.
Now, ten years later, she is experiencing weakness and pain in her left arm, and she has difficulty lifting it.
My mother is in her 60s, does not have hypertension, diabetes, or hyperlipidemia, but she does have anemia and low blood pressure.

1.
Is it necessary to surgically remove the metal pins?
2.
What potential complications could arise from the removal of the pins?
3.
What type of surgery would you recommend as the safest option?
4.
Will health insurance cover the costs associated with this surgery?
Thank you for your assistance!

Pengpeng, 20~29 year old female. Ask Date: 2018/03/27

Dr. Li Yongheng reply Orthopedics

Hello, your mother underwent internal fixation surgery with a bone screw on her left clavicle ten years ago.
Recently, she has been experiencing weakness, pain, and difficulty lifting her left arm.
The cause of these symptoms may not necessarily be related to the bone screw.
Therefore, removing the screw may not improve her current symptoms unless it can be confirmed that the screw is protruding and affecting the range of motion in her left shoulder joint.
After the removal of the screw, the holes left in the clavicle may weaken it, making it more susceptible to fractures from falls within three months.
Health insurance can cover the costs associated with the removal surgery.

Reply Date: 2018/03/27

More Info

When dealing with orthopedic recovery, particularly after significant trauma such as a car accident, the presence of steel rods or plates can raise various concerns for patients and their families. In your mother's case, having undergone surgery to insert steel rods after a severe injury, it's understandable that you have questions regarding her current symptoms and the potential need for further surgical intervention.

1. Need for Removal of Steel Rods: The decision to remove steel rods or any orthopedic hardware typically depends on several factors, including the patient's current symptoms, the stability of the bone, and the potential for future complications. In your mother's case, if she is experiencing significant pain, weakness, and limited mobility in her left arm, it may be worth discussing with her orthopedic surgeon whether the steel rods are contributing to these issues. In some cases, hardware can cause discomfort or irritation, especially if it is prominent or if there has been any change in the surrounding tissues over time. However, if the hardware is stable and not causing any complications, the surgeon may recommend leaving it in place.

2. Potential Complications from Removal: If the decision is made to remove the steel rods, there are potential risks and complications associated with the surgery. These can include infection, nerve damage, or the possibility of the original injury site becoming unstable if the hardware was providing necessary support. Additionally, there is a risk of postoperative pain and the need for rehabilitation to regain strength and mobility in the affected area. It's essential to weigh these risks against the potential benefits of removing the hardware, especially if it is believed to be contributing to her current symptoms.

3. Recommended Surgical Approach: The safest surgical approach for hardware removal will depend on the specific circumstances of your mother's case, including her overall health, the location of the hardware, and the complexity of the surgery. Minimally invasive techniques are often preferred when possible, as they can reduce recovery time and minimize tissue damage. However, the surgeon will determine the best approach based on their assessment of her condition.

4. Insurance Coverage: Regarding insurance coverage for the procedure, it is crucial to check with your health insurance provider to understand what is covered under her plan. In many cases, if the surgery is deemed medically necessary due to ongoing pain or dysfunction, it may be covered. Your mother's orthopedic surgeon's office can often assist with this process by providing the necessary documentation to justify the need for surgery.

In summary, it is essential for your mother to have a thorough evaluation by her orthopedic surgeon to discuss her symptoms and the potential need for hardware removal. The surgeon can provide personalized recommendations based on her specific situation, including the risks and benefits of surgery, the best surgical approach, and insurance coverage options. Open communication with her healthcare team will be key in navigating her recovery and ensuring the best possible outcome.

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