Pain After Removing Metal Plates and Screws from Leg Fracture

Will there be pain at the wound site after the removal of the metal plates and screws from a leg fracture?

I was in a car accident at the end of last year, and my calf was fractured.
After surgery, I had metal plates and screws inserted.
Last week, on December 6, the plates and screws were removed.
I was discharged three days later, and for a few days, the wound didn't hurt much.
However, for some reason, it has become more painful these past few days, and the pain feels like a throbbing sensation.
My wound was covered with cosmetic adhesive after the surgery, so I am unaware of its condition.
Could you please explain why the pain in the wound has increased? After returning home, I immediately resumed work since I could walk without any issues.
However, the pain has intensified to the point where I can no longer go up and down stairs, which I was able to do before.
Could this indicate that the wound has worsened?

Yan, 60~69 year old female. Ask Date: 2021/12/14

Dr. Wang Shouji reply Orthopedics

Hello, even if the wound is covered with cosmetic adhesive, you can gauge its condition by whether it continues to ooze blood.
If, after resting, it does not heal and remains painful, it is advisable to return for a check-up.
Changhua Hospital cares about your health.
Sincerely, Dr.
Wang Shou-ji.

Reply Date: 2021/12/14

More Info

After undergoing surgery to remove metal plates and screws from a leg fracture, experiencing increased pain can be concerning and confusing. It's important to understand that post-operative pain can arise from various factors, and it doesn't necessarily indicate a worsening condition. Here are some potential reasons for the increased pain you are experiencing:
1. Healing Process: After surgery, the body goes through a healing process that can involve inflammation and tissue repair. This process can sometimes lead to increased pain as the body reacts to the surgical intervention. The pain may be more pronounced as the anesthesia wears off and the initial post-operative numbness subsides.

2. Nerve Sensitivity: The surgical procedure may have affected nearby nerves, leading to heightened sensitivity or pain in the area. This phenomenon, known as neuropathic pain, can occur even after the physical structures have been repaired. It may take time for the nerves to settle down and for the pain to diminish.

3. Scar Tissue Formation: As the incision heals, scar tissue can form, which may lead to discomfort or pain. Scar tissue can sometimes adhere to surrounding tissues, leading to a sensation of tightness or pulling, especially when moving the leg or engaging in activities.

4. Activity Level: You mentioned returning to work and being active shortly after surgery. While it's great that you feel capable of moving around, engaging in too much activity too soon can exacerbate pain. The body needs time to adjust after the removal of hardware, and overexertion can lead to increased discomfort.

5. Infection or Complications: Although less common, increased pain can sometimes indicate an infection or other complications. Signs of infection may include redness, swelling, warmth around the incision site, or fever. If you notice any of these symptoms, it's crucial to contact your healthcare provider.

6. Muscle Strain: After surgery, the muscles around the fracture site may be weak or deconditioned. If you are using those muscles more than they are ready for, it can lead to strain and pain. Gradually increasing your activity level and incorporating physical therapy can help strengthen those muscles and reduce pain over time.

Given your situation, it's essential to monitor your symptoms closely. If the pain persists or worsens, or if you experience any other concerning symptoms, you should reach out to your healthcare provider for a thorough evaluation. They may recommend imaging studies to assess the healing process or provide guidance on pain management strategies.

In the meantime, consider the following tips to help manage your pain:
- Rest and Elevation: Allow your leg to rest and elevate it when possible to reduce swelling and discomfort.

- Ice Therapy: Applying ice to the area can help alleviate pain and reduce inflammation.

- Pain Management: Over-the-counter pain medications, as recommended by your doctor, can help manage discomfort.

- Gradual Activity: Gradually increase your activity level, listening to your body and avoiding movements that exacerbate pain.

Ultimately, while it can be disheartening to experience increased pain after surgery, it is not uncommon. With proper care and attention, you should see improvement as your body continues to heal. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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