Can Minor Impact After Shoulder Surgery Cause Titanium Screw Failure? - Orthopedics

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Post-operative care for fracture surgery?


I recently underwent surgery for a displaced proximal humeral fracture on my right shoulder, using plates and screws for fixation, about three to four days ago.
However, while walking, I accidentally bumped my right shoulder against a wall.
Although the impact was minor, I felt a sharp pain in the surgical area, but there was no other pain afterward.
Could this potentially cause the screws to break? I've heard that titanium alloy screws are relatively brittle.

Bobo, 20~29 year old female. Ask Date: 2022/09/10

Dr. Shi Guozheng reply Orthopedics


If the upper arm can still move, it may not be fractured.
The safest approach is to get an X-ray to confirm the diagnosis.

Reply Date: 2022/09/10

More Info


After undergoing surgery for a proximal humeral fracture with fixation using plates and screws, it is understandable to be concerned about the impact of minor trauma on the surgical site. In your case, you experienced a minor collision with a wall just a few days post-surgery, which understandably raises questions about the integrity of the titanium screws used in your fixation.

Firstly, titanium screws are widely used in orthopedic surgeries due to their strength, biocompatibility, and resistance to corrosion. While it is true that titanium is a strong material, it is also somewhat flexible, which helps it absorb some stress without fracturing. The design and placement of these screws are intended to withstand normal physiological loads, including minor impacts. However, the healing process of the bone and surrounding tissues is critical in determining the overall stability of the fixation.

In the immediate aftermath of surgery, the bone is still in a fragile state as it begins the healing process. The initial few weeks post-surgery are crucial, and the bone may not yet have regained its full strength. Therefore, while minor impacts may not necessarily lead to screw failure, they can potentially disrupt the healing process or cause discomfort. If you felt pain at the site of the surgery after the impact, it is essential to monitor this closely.

Here are some considerations regarding your situation:
1. Pain Response: The pain you experienced after the impact could be a normal response to trauma, especially given that the area is still healing. However, if the pain persists or worsens, it may indicate a need for further evaluation.

2. Screw Integrity: It is unlikely that a minor impact would cause immediate failure of the titanium screws, especially if you did not experience significant pain or swelling afterward. However, if you have concerns about the screws or the stability of the fixation, it is advisable to consult your orthopedic surgeon.

3. Healing Process: The healing of bone after surgery typically involves a process called callus formation, where new bone tissue begins to bridge the fracture site. This process can take several weeks to months, and during this time, it is crucial to avoid activities that could stress the surgical site.

4. Follow-Up Care: Regular follow-up appointments with your surgeon are essential to monitor the healing process. X-rays may be taken to assess the position of the screws and the healing of the bone. If you have any concerns about your recovery or the impact of the collision, do not hesitate to reach out to your healthcare provider.

5. Activity Modification: It is advisable to avoid any activities that could put undue stress on your shoulder during the early stages of recovery. This includes avoiding heavy lifting, sudden movements, or any activities that could lead to falls or further impacts.

In conclusion, while minor impacts may not directly lead to the failure of titanium screws, they can affect the healing process. It is essential to listen to your body and communicate with your healthcare provider about any concerns you have. If you experience persistent pain, swelling, or any other unusual symptoms, seek medical advice promptly. Your orthopedic surgeon can provide the best guidance based on your specific situation and recovery progress.

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