Should You Remove a Loose Screw After Clavicle Surgery?

Nail problems

Hello doctor, I had clavicle surgery 2-3 years ago, where a plate and screws were used for fixation.
Recently, I've been experiencing soreness in my shoulder and arm, and sometimes numbness.
After an X-ray, it was found that one of the screws has fallen out.
Is it necessary to have it removed?

A-Bin, 30~39 year old female. Ask Date: 2018/07/06

Dr. Wang Zhengqi reply Orthopedics

Hello, if there is a loose screw and the physician assesses that the discomfort is caused by the loose screw, removal of the screw may be considered.

Reply Date: 2018/07/06

More Info

After undergoing clavicle surgery with the placement of plates and screws, it's not uncommon to experience discomfort or pain, especially if a screw has become loose or has fallen out. In your case, where you have recently experienced shoulder and arm pain along with numbness, it's essential to address the issue of the loose screw.

Should You Remove a Loose Screw?
1. Assessment of Symptoms: The first step is to evaluate the symptoms you're experiencing. Pain and numbness can be indicative of several issues, including nerve compression or irritation, which could be exacerbated by the presence of a loose screw. If the screw is causing mechanical irritation to surrounding tissues, it may be advisable to remove it.

2. Potential Risks of Leaving the Screw: Leaving a loose screw in place can lead to several complications:
- Pain and Discomfort: As you've experienced, a loose screw can cause ongoing pain and discomfort, potentially affecting your range of motion and overall function.

- Nerve Damage: If the screw is pressing against a nerve, it could lead to numbness or tingling sensations in your arm or hand. This is particularly concerning and should be evaluated by a healthcare professional.

- Infection Risk: Although rare, any foreign body in the body can increase the risk of infection, especially if the screw is not stable.

3. Surgical Considerations: If the decision is made to remove the screw, the procedure is generally straightforward, especially if the surgery is performed by an experienced orthopedic surgeon. The surgeon will assess the site, ensure that the surrounding tissues are healthy, and remove the screw with minimal disruption.

4. Recovery and Rehabilitation: Post-surgery, you may need a period of rehabilitation to regain strength and mobility in your shoulder. Physical therapy can help in restoring function and alleviating pain.

5. Consultation with Your Surgeon: It's crucial to have a detailed discussion with your orthopedic surgeon regarding the loose screw. They can provide personalized advice based on your specific situation, including the condition of the surrounding tissues, the stability of the clavicle, and your overall health.

Conclusion
In summary, if you have a loose screw after clavicle surgery and are experiencing pain and numbness, it is advisable to consult with your orthopedic surgeon. They will evaluate the necessity of removing the screw based on your symptoms and the potential risks involved. Early intervention can help prevent further complications and improve your quality of life. Remember, your health and comfort should always be the priority, and addressing these issues promptly is essential for a successful recovery.

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