Postoperative care for patellar fracture?
Do I need to remove the nails and wires after one year?
Cheng Cheng, 30~39 year old female. Ask Date: 2022/02/16
Dr. Chen Yongxue reply Orthopedics
Hello young man, it's good to have it removed; keeping it serves no purpose and will only increase the chance of wear and tear.
Thank you.
Reply Date: 2022/02/16
More Info
After undergoing surgery for a patellar fracture, the question of whether to remove screws and wires is a common concern among patients. The decision to remove these hardware components is influenced by several factors, including the type of fixation used, the patient's healing progress, and any complications that may arise.
In general, screws and wires used in the fixation of a patellar fracture are designed to remain in place permanently unless they cause problems. Many orthopedic surgeons prefer to leave the hardware in place if it is not causing any discomfort or complications. This is because the removal of screws and wires can involve another surgical procedure, which carries its own risks, including infection, nerve damage, and complications related to anesthesia.
However, there are specific situations where removal may be recommended:
1. Pain or Discomfort: If the hardware is causing persistent pain or discomfort, removal may be necessary. Some patients report that the presence of screws or wires can lead to irritation of surrounding tissues, especially during activities that involve bending or straightening the knee.
2. Infection: If there is any sign of infection at the site of the hardware, it may need to be removed to prevent further complications.
3. Hardware Migration: In some cases, screws or wires may shift from their original position, which can lead to pain or mechanical issues in the joint. If this occurs, removal may be necessary.
4. Patient Preference: Some patients may request removal for peace of mind, especially if they are concerned about the long-term presence of foreign objects in their body.
5. Radiological Findings: If follow-up imaging (like X-rays) shows that the hardware is not functioning as intended or is causing issues, the surgeon may recommend removal.
Regarding the timeline for removal, it is typically not necessary to remove screws and wires one year post-surgery unless there are specific indications. Many patients continue to have these implants in place for years without any issues. The decision should be made in consultation with your orthopedic surgeon, who can assess your individual situation and provide personalized recommendations based on your healing progress and any symptoms you may be experiencing.
In terms of recovery and rehabilitation, it is essential to follow your surgeon's advice regarding weight-bearing activities and physical therapy. Engaging in a structured rehabilitation program can help improve your knee function and reduce pain, regardless of whether the hardware remains in place.
In summary, while it is not always necessary to remove screws and wires after patellar fracture surgery, the decision should be based on individual circumstances, including pain, complications, and the surgeon's assessment. Always discuss your concerns and preferences with your orthopedic surgeon to make an informed decision that aligns with your recovery goals.
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