Will Removing a Fracture Plate Worsen My Hypertrophic Scar? - Orthopedics

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Removing a fracture plate from a previous surgical site can indeed raise concerns about the potential impact on existing hypertrophic scars, especially in individuals predisposed to keloid or hypertrophic scar formation. Hypertrophic scars are raised scars that occur when the body produces too much collagen during the healing process. In your case, since you have a history of hypertrophic scarring, it is understandable that you are worried about the possibility of worsening your scar after the removal of the fracture plate.

When a fracture plate is removed, particularly if it involves making an incision over an existing scar, there is a risk that the scar could become more pronounced. This is due to several factors:
1. Tissue Trauma: The act of cutting through the skin and underlying tissues can cause additional trauma, which may lead to increased collagen production and, consequently, a more prominent scar.

2. Inflammatory Response: Surgery can trigger an inflammatory response, which is part of the body's natural healing process. In individuals with a predisposition to hypertrophic scarring, this response can be exaggerated, leading to more significant scarring.

3. Scar Location: If the incision for the plate removal is made directly over the existing scar, it may disrupt the healing process of the scar tissue, potentially leading to a larger and more raised scar.

4. Postoperative Care: The way the wound is managed post-surgery can also influence scar formation. Proper wound care, including keeping the area clean and moisturized, and possibly using silicone gel sheets or pressure garments, can help minimize scar formation.

In terms of management, here are some considerations:
- Consultation with Your Surgeon: It is crucial to discuss your concerns with your surgeon before the procedure. They can provide insights based on their experience and may suggest techniques to minimize scarring, such as using a different incision pattern or employing advanced closure techniques.

- Scar Management Post-Surgery: After the removal of the plate, you may want to start scar management treatments as soon as the incision has healed. Options include silicone gel sheets, silicone ointments, or even corticosteroid injections if the scar begins to thicken again.

- Monitoring and Follow-Up: Regular follow-up appointments with your healthcare provider can help monitor the scar's progression and allow for timely interventions if the scar begins to worsen.

- Consideration of Other Treatments: If the scar does become hypertrophic, treatments such as laser therapy, cryotherapy, or surgical revision may be options to consider in the future.

In summary, while there is a risk that removing the fracture plate could worsen your existing hypertrophic scar, careful planning and management can help mitigate this risk. It is essential to have an open dialogue with your surgeon about your concerns and to follow a comprehensive postoperative care plan to promote optimal healing and minimize scar formation.