Post-Surgery Issues: Broken Pins After Bunion Surgery

Postoperative care for hallux valgus surgery?

Last summer, after undergoing surgery for hallux valgus on my right big toe, my follow-up visits were normal.
However, during a follow-up appointment in early February this year, the doctor informed me that the fixation screw had broken.
Is this normal? Although the doctor said there is no major issue, I would like to know if this could be caused by any bad habits or excessive physical activity.
Additionally, is it necessary to remove the broken screw? What are the potential effects of leaving it in the body? If surgery is required to remove it, will I be able to walk normally right away, or will I need to use crutches for a while? Thank you for patiently answering my questions.

Bùdīng, 10~19 year old female. Ask Date: 2023/03/11

Dr. Shi Guozheng reply Orthopedics

If the bone screw has broken but the bone has already healed, it may not require any intervention.
However, if the broken screw irritates nearby tissues and causes symptoms, it should be removed.
After the surgery, recovery typically takes a few days, but whether you can walk immediately should be discussed with the surgeon.

Reply Date: 2023/03/11

More Info

After bunion surgery, experiencing issues such as broken pins can be concerning for patients. It’s important to understand that while the occurrence of broken pins is not ideal, it can happen for various reasons. In your case, the fact that your doctor indicated there was "no major issue" is reassuring, but it’s natural to want to know more about the potential causes and implications.

Firstly, the breakage of surgical pins can occur due to several factors, including the type of activity you engage in post-surgery, the quality of the bone healing, and the overall stability of the fixation. If you have resumed high-impact activities or sports too soon after surgery, this could contribute to stress on the pins, leading to breakage. Additionally, if the bone has not healed sufficiently, the pins may be subjected to excessive forces, resulting in failure.
It’s also worth noting that some patients may have a higher risk of complications due to underlying conditions such as osteoporosis, which can affect bone density and healing. If you have any concerns about your bone health, it might be beneficial to discuss this with your healthcare provider.

Regarding whether the broken pin needs to be removed, this decision typically depends on several factors, including the location of the pin, the extent of the break, and whether it is causing any pain or complications. In many cases, if the pin is not causing any issues and the bone is healing properly, it may be left in place. However, if there is a risk of infection, irritation, or if the pin is causing pain, your doctor may recommend removal.

If you do require a second surgery to remove the pin, the recovery process may vary. Generally, after pin removal, patients are advised to follow a rehabilitation protocol that may include the use of crutches or a walking aid for a period of time, especially if the area is still tender or if there is a risk of re-injury. The timeline for returning to normal activities can vary based on individual healing rates and the extent of the surgery. It’s crucial to follow your surgeon's advice regarding weight-bearing activities and rehabilitation exercises.

In summary, while broken pins after bunion surgery can be concerning, they are not always indicative of a serious problem. Factors such as activity level, bone health, and the specifics of your surgical procedure all play a role in the healing process. Always consult with your healthcare provider for personalized advice and to determine the best course of action for your recovery. They can provide guidance on whether the pin should be removed and what the recovery process will entail, ensuring you return to your normal activities safely and effectively.

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