the Need for Hardware Removal After Arm Fracture Surgery

Removal of metal screws issue

Hello Doctor, I had surgery on October 27th of last year following a car accident, primarily for a right distal humeral fracture.
The current condition, as shown in the photos [link], has improved with ongoing rehabilitation, but I still experience slight differences in the angles when extending and flexing my arm, along with occasional tightness and discomfort.
The most noticeable issue remains discomfort due to friction around the elbow area.
Recent X-rays can be viewed here [link].
I am considering the removal of the metal plate and screws (both out-of-pocket expenses) in the future, but I am concerned because the incision is approximately 15-20 cm long, and my occupation involves caring for children.
Therefore, I would like to ask: 1.
Based on the photos, do you recommend removal (I am worried about nerve damage or worsening recovery)? 2.
How many days of hospitalization would be required? 3.
After the removal, will I be able to perform caregiving tasks for young children? 4.
How long will rehabilitation be necessary after the removal? Thank you, Doctor.

Zhang, 20~29 year old female. Ask Date: 2024/03/19

Dr. Chen Yongxue reply Orthopedics

Each person's recovery varies.
Whether or when to remove it should be discussed with your attending physician.
Generally, a hospital stay of about 3 to 4 days is required post-surgery, and it is advisable to avoid vigorous exercise for at least 3 months.
Thank you.

Reply Date: 2024/03/19

More Info

After an arm fracture surgery, particularly one involving the distal humerus, the decision to remove hardware such as plates and screws is a significant consideration. Here’s a comprehensive response to your questions based on the information provided and general medical knowledge.

1. Should the hardware be removed?
The decision to remove hardware is often based on several factors, including the presence of discomfort, the potential for complications, and the specific needs of the patient. In your case, if you are experiencing persistent discomfort, particularly a sensation of friction at the elbow, it may be advisable to consider hardware removal. However, there are risks involved, such as potential nerve damage or complications that could arise from the surgery itself. Consulting with your orthopedic surgeon is crucial, as they can assess the specific situation, including the position of the hardware and the healing status of the bone.

2. How long will hospitalization be required?
Typically, the hospitalization for hardware removal can vary based on the complexity of the surgery and the individual’s health status. Generally, patients may expect to stay in the hospital for about 1 to 3 days post-surgery. This allows for monitoring and management of any immediate postoperative complications. Your surgeon will provide a more precise estimate based on your specific case.

3. Can you care for children after hardware removal?
After the removal of the hardware, the ability to engage in activities such as caring for children will depend on your pain level, mobility, and the advice of your healthcare provider. Initially, you may experience some discomfort and limited range of motion, which could affect your ability to perform certain tasks. It is essential to follow your surgeon's recommendations regarding activity restrictions post-surgery. They may advise a gradual return to normal activities, including caring for children, based on your recovery progress.

4. How long will rehabilitation be needed after hardware removal?
Rehabilitation following hardware removal can vary widely among individuals. Generally, physical therapy may be recommended to restore strength, flexibility, and function to the elbow joint. The duration of rehabilitation can range from a few weeks to several months, depending on the extent of the surgery, your pre-existing condition, and how well you respond to therapy. Regular follow-ups with your physical therapist and orthopedic surgeon will help tailor the rehabilitation program to your specific needs.

In summary, the decision to remove hardware after arm fracture surgery should be made collaboratively with your healthcare provider, considering the potential benefits and risks. While hardware removal can alleviate discomfort and improve function, it is essential to weigh these factors carefully. Postoperative care, including rehabilitation, will play a crucial role in your recovery, helping you regain strength and mobility in your arm. Always follow your healthcare provider's guidance for the best outcomes.

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