Concerns About Broken Screws After Foot Surgery: What You Need to Know - Orthopedics

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Broken nail?


Hello Doctor: I had surgery on January 5th this year for my foot arch, where they inserted a self-funded steel plate and seven steel screws.
During my follow-up appointment on March 20th, the doctor reviewed my X-rays and said that my bone is almost healed, but one of the screws has broken.
The doctor mentioned that this does not affect the healing process.
However, my attending physician spoke very casually about it, but I am really worried because I previously had a poor healing outcome due to a broken screw from a procedure covered by insurance, which led to another surgery.
I am genuinely concerned about whether this will have an impact and if I will need another surgery.
I feel very heavy-hearted!

Tommy Li, 30~39 year old female. Ask Date: 2018/03/28

Dr. Wang Shouji reply Orthopedics


If a fracture has already healed, there is no issue with reoperating to complete the procedure.
The breakage of metal screws occurs before the fracture has healed, often due to excessive weight-bearing leading to metal fatigue, which is a common clinical issue and not typically a major concern.

Reply Date: 2018/03/28

More Info


It’s understandable to feel anxious about the implications of a broken screw following foot surgery, especially given your previous experiences with healing complications. Let's break down the situation and address your concerns.

Firstly, it’s important to recognize that the presence of broken screws or pins in orthopedic surgery is not uncommon. In many cases, if a screw breaks but does not cause any pain, instability, or misalignment of the bone, it may not require surgical intervention. Your doctor’s reassurance that the broken screw does not affect your healing is a positive sign, indicating that your bone is healing well and that the integrity of the surgical site remains intact.

However, your concerns are valid, especially considering your history of complications with healing. The fact that you previously experienced issues with a different set of screws can understandably heighten your anxiety about the current situation. Here are some key points to consider regarding broken screws and their potential impact on your recovery:
1. Bone Healing Process: The healing of bone after surgery is a complex process that involves the formation of new bone tissue. If your doctor has indicated that your bone is healing well, this is a good sign. The broken screw may not impede this process, especially if the surrounding bone is stable and strong.

2. Monitoring and Follow-Up: Regular follow-up appointments and imaging (like X-rays) are crucial in monitoring your recovery. If your doctor has scheduled follow-ups, it’s important to attend these appointments to ensure that your healing continues as expected. If any issues arise, they can be addressed promptly.

3. Symptoms to Watch For: While a broken screw may not always necessitate further surgery, it’s essential to be vigilant about any new symptoms. If you experience increased pain, swelling, or any changes in your ability to bear weight on your foot, you should contact your healthcare provider immediately. These could be signs that the situation requires further evaluation.

4. Surgical Considerations: In cases where a broken screw does lead to complications, such as pain or instability, a revision surgery might be necessary. However, this is typically considered a last resort. Your doctor will weigh the risks and benefits before recommending any additional procedures.

5. Psychological Impact: It’s also important to address the emotional toll that these experiences can take. Anxiety about your recovery is normal, but it’s crucial to communicate these feelings with your healthcare provider. They can offer support and possibly refer you to a counselor or therapist who specializes in helping patients cope with medical anxiety.

6. Patient Advocacy: If you feel uncertain about your treatment plan or the implications of the broken screw, don’t hesitate to seek a second opinion. It’s your right as a patient to understand your condition fully and to feel confident in your treatment plan.

In conclusion, while the presence of a broken screw can be concerning, it does not automatically mean that you will require another surgery. Continuous monitoring and communication with your healthcare provider are key to ensuring a successful recovery. Remember, your health and peace of mind are paramount, so don’t hesitate to voice your concerns and seek clarity on your treatment plan.

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