Prominent Screws After Clavicle Fracture Surgery

Protrusion of the steel pin after a clavicle fracture?

Hello, a few weeks ago I was in a car accident that resulted in a fractured clavicle, and I underwent surgery for internal fixation.
It has not been a month yet, and I can clearly feel the metal screws protruding.
Is this normal, or could it be a sign of displacement? I occasionally experience soreness and pain.
If there is indeed a displacement, will I definitely need another surgery? What can be done to improve the situation? If I leave it alone, will it protrude more? I'm really afraid of having to undergo another surgery...

Xiao Liu, 10~19 year old female. Ask Date: 2020/10/09

Dr. Chen Bochen reply Orthopedics

It is common to feel the steel plate after surgery due to the thin skin and minimal tissue over the clavicle.
If there is any concern about displacement, it is not accurate to guess.
It is best to consult your surgeon and get an X-ray.
Don't worry too much on your own.
Wishing you a speedy recovery!

Reply Date: 2020/10/09

More Info

After a clavicle fracture surgery, it is not uncommon for patients to feel prominent screws or hardware beneath the skin. This can be concerning, especially if you are experiencing pain or discomfort. Let's break down your concerns regarding the prominent screws and the overall recovery process.

1. Prominent Screws: It is generally normal to feel the screws or plates used in internal fixation after surgery. The prominence of the screws can be due to several factors, including the surgical technique, the type of hardware used, and individual anatomy. In many cases, the hardware may be palpable, especially if the incision is made close to the surface of the skin. However, if the screws are significantly protruding or if you are experiencing increased pain, it is essential to consult your orthopedic surgeon. They can assess whether the hardware is in the correct position or if there has been any displacement.

2. Pain and Discomfort: Occasional soreness or discomfort around the surgical site is common during the recovery phase. This can be attributed to inflammation, healing tissue, or the presence of the hardware itself. However, if the pain is severe or worsening, it is crucial to seek medical advice. Your doctor may recommend imaging studies, such as an X-ray, to evaluate the position of the screws and the healing of the fracture.

3. Hardware Removal: In some cases, if the hardware is causing significant discomfort or if it is deemed to be problematic, your surgeon may recommend its removal. This is typically considered after the bone has fully healed, which can take several months. The decision to remove hardware is based on the patient's symptoms, the position of the hardware, and the overall healing process.

4. Management of Prominent Screws: If the screws are prominent but not causing significant issues, your doctor may suggest a conservative approach, which includes monitoring the situation. Physical therapy may also be beneficial to improve strength and range of motion in the shoulder, which can help alleviate some discomfort. If the screws are causing pain, your surgeon may discuss options for pain management, including medications or injections.

5. Long-term Outlook: If left untreated, prominent screws may not necessarily become more pronounced, but they can cause ongoing discomfort. It is essential to maintain regular follow-up appointments with your orthopedic surgeon to monitor your recovery. They can provide guidance on when it might be appropriate to consider hardware removal if symptoms persist.

In conclusion, while it is common to feel prominent screws after clavicle fracture surgery, it is essential to communicate any concerns with your healthcare provider. They can provide a thorough evaluation and determine the best course of action based on your specific situation. Remember, recovery takes time, and it is crucial to follow your surgeon's recommendations for rehabilitation and follow-up care to ensure the best possible outcome.

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