Does Removing a Steel Pin Help Healing After a Femur Fracture?

Does removing a steel rod from a femur fracture help with bone healing?

I had a car accident on July 5th, resulting in a closed fracture of my right femur, with a clean break between two segments.
I underwent surgery at Yuanlin Christian Hospital on the same day.
During my follow-up appointment on September 28th, it was evident that the bone was gradually healing, but the doctor mentioned that the healing process was slow and recommended the removal of a steel rod to promote growth.
However, after researching online, I found that this removal could potentially lead to limb length discrepancy.

Nina, 20~29 year old female. Ask Date: 2018/09/28

Dr. Chen Yongxue reply Orthopedics

Hello, as mentioned in your letter, your bone fracture is very "clean," which likely means there are not many fragments.
In this situation, if the bone healing is too slow after surgery (especially when using intramedullary nails for fixation), it is possible to remove one of the screws to allow for compression at the fracture site during weight-bearing, which can accelerate the healing process.
Regarding the issue of length discrepancy, this typically occurs in comminuted fractures.

Reply Date: 2018/09/28

More Info

Removing a steel pin after a femur fracture can indeed play a significant role in the healing process, but it is essential to understand the context and implications of such a decision. In your case, where you experienced a closed femur fracture and underwent surgery, the primary goal of using a steel pin (or intramedullary nail) is to stabilize the fracture and allow for proper healing.
When a fracture occurs, the body initiates a healing process that involves inflammation, bone formation, and remodeling. The presence of a steel pin helps to maintain alignment and stability during the initial healing phase. However, once the bone has sufficiently healed, the pin may no longer be necessary. In some cases, the removal of the pin can facilitate further healing and remodeling of the bone.

The concern about potential complications, such as limb length discrepancy (commonly referred to as "long-short leg syndrome"), is valid. This can occur if the bone does not heal properly or if there is a significant difference in the healing rates of the two segments of the fractured bone. However, if the fracture has healed well and the alignment is correct, the risk of developing a leg length discrepancy after pin removal is generally low.

In your situation, the doctor has indicated that the bone is healing slowly, which may warrant the removal of the pin to encourage further bone growth. This decision is often based on radiographic evidence and clinical judgment. If the pin is impeding the healing process or causing discomfort, its removal could be beneficial.
After the removal of the pin, it is crucial to follow the rehabilitation protocol recommended by your healthcare provider. This may include physical therapy to strengthen the muscles around the femur and improve range of motion. Engaging in weight-bearing activities as tolerated can also promote bone remodeling and healing.
It is important to note that while the removal of the pin can help in certain cases, it is not a guaranteed solution for all patients. Each case is unique, and the decision should be made collaboratively between you and your orthopedic surgeon, considering your specific circumstances, the quality of the bone healing, and any potential risks involved.

In summary, removing a steel pin can aid in the healing process after a femur fracture, especially if the bone is healing slowly. However, it is essential to weigh the benefits against the potential risks, such as leg length discrepancy. Close communication with your healthcare provider and adherence to post-operative rehabilitation will be key to achieving the best possible outcome.

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