Concerns About Exposed Bone Pins After Finger Fracture Surgery

Exposed bone screw

Hello doctor, I have a fracture in my thumb.
The attending physician used two bone screws for stabilization, and one of them is protruding outside, possibly due to improper placement during the surgery.
The doctor did not reinsert it during my follow-up visit.
Recently, when I had my dressing changed, it seemed that the position of that screw has shifted a bit, but I am not experiencing any discomfort.
I am scheduled to have the screws removed next Thursday.
Should I return for an earlier appointment to check if the screw has displaced?

Hong, 10~19 year old female. Ask Date: 2022/08/13

Dr. Zhan Xian reply Orthopedics

If there is no significant movement of the bone screw and the wound does not show redness, swelling, or discharge, you can return for your follow-up appointment as originally scheduled.
If you experience any discomfort, please come in for an earlier visit.

Reply Date: 2022/08/13

More Info

After a finger fracture surgery, concerns about exposed bone pins and their stability are quite common among patients. In your case, where one of the bone pins is partially exposed and has shown some movement, it is understandable to feel anxious about the situation. Here’s a detailed response to your concerns, along with some medical insights.

Firstly, it’s important to recognize that the use of bone pins (or screws) is a standard procedure in orthopedic surgery, particularly for fractures that require stabilization. These pins are designed to hold the fractured bone fragments together, allowing for proper healing. However, if a pin is exposed, it can lead to potential complications such as infection or irritation of the surrounding tissues.

Regarding your specific situation, if the exposed pin has not caused you any discomfort or pain, that is a positive sign. However, any movement of the pin could indicate that it is not securely anchored in the bone, which might compromise the stability of the fracture site. It is crucial to monitor the situation closely. If you notice any changes, such as increased swelling, redness, or pain around the area, it would be advisable to seek medical attention sooner rather than later.

You mentioned that you have a follow-up appointment scheduled for next Thursday to have the pin removed. If you feel that the pin has moved significantly or if you have any concerns about the integrity of the fixation, it would be prudent to contact your surgeon’s office and discuss your observations. They may recommend an earlier visit to assess the situation and ensure that the healing process is not being jeopardized.

In terms of healing, the stability of the fracture is paramount. If the pin is moving, it could potentially lead to malunion (where the bone heals improperly) or nonunion (where the bone fails to heal). This is especially critical in finger fractures, as proper alignment is essential for optimal function and range of motion post-recovery.

Additionally, it’s worth noting that the healing process can vary significantly from person to person, influenced by factors such as age, overall health, and adherence to post-operative care instructions. Engaging in any activities that could stress the healing bone or the fixation device should be avoided until you receive clearance from your surgeon.

In summary, while the absence of discomfort is reassuring, the movement of the exposed pin warrants attention. It is always better to err on the side of caution when it comes to post-surgical care. If you have any doubts or concerns, do not hesitate to reach out to your healthcare provider for guidance. They are best positioned to evaluate your specific case and determine the appropriate course of action. Your health and recovery are the top priorities, and ensuring that everything is healing correctly will contribute to a successful outcome.

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