Calcaneal Fractures: When to Remove Surgical Pins? - Orthopedics

More Info

---

Calcaneal fractures, particularly those that are comminuted, can be quite complex and require careful management. Your boyfriend's situation, involving a comminuted calcaneal fracture followed by surgical fixation with pins, is not uncommon. The question of when to remove surgical pins is crucial for both recovery and long-term function.

In general, the timing for the removal of surgical pins or hardware after a fracture depends on several factors, including the type of fracture, the method of fixation, the healing process, and the patient's overall health. For calcaneal fractures, particularly those that are comminuted, the healing process can take longer due to the complexity of the injury and the load-bearing nature of the heel bone.

Typically, surgical pins are left in place for a minimum of 6 to 12 weeks, depending on the healing observed through clinical evaluation and imaging studies like X-rays. In cases of comminuted fractures, it may be advisable to wait longer, often around 3 to 6 months, before considering removal. This allows for adequate bone healing and stability, which is crucial to prevent complications such as re-fracture or malunion.

In your boyfriend's case, since he underwent surgery on December 13 and is experiencing pain at the pin sites, it is understandable that you are concerned about the timing of pin removal. The fact that the middle pin is becoming encased in skin suggests that it may be irritating the surrounding tissue, which can lead to discomfort. However, the decision to remove the pins should ideally be based on radiological evidence of healing and the surgeon's clinical judgment.

If the surgeon has recommended waiting until April for the removal of the pins, it is likely based on their assessment of the fracture's healing progress. While it may seem like a long time, especially if there is discomfort, it is essential to prioritize the integrity of the healing bone. Removing the pins too early could jeopardize the healing process and lead to further complications.

If you have concerns about the pain or the healing process, it would be beneficial to have a follow-up appointment with the surgeon. They may consider performing an X-ray to evaluate the healing status of the fracture and the surrounding bone. If the X-ray shows good healing, the surgeon might reassess the need for pin removal sooner than initially planned.

In summary, while there is no one-size-fits-all answer for when to remove surgical pins after a calcaneal fracture, the general recommendation is to wait until adequate healing has occurred, which can take several months. Communication with the treating physician is key, and if there are ongoing concerns about pain or healing, seeking a second opinion or further evaluation is always a reasonable course of action.