the Risks of Leaving Bone Screws in After Surgery - Orthopedics

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When it comes to the decision of whether to leave bone screws and plates in place after surgery, such as in the case of an open humeral fracture, there are several factors to consider. The primary concern is the potential for complications or long-term effects that may arise from leaving the hardware in the body.


Risks of Leaving Bone Screws and Plates in Place
1. Infection: One of the most significant risks associated with retained hardware is the potential for infection. If bacteria manage to colonize around the screws or plates, it can lead to a deep infection that may require further surgical intervention.

2. Hardware Failure: Although rare, there is a possibility that the screws or plates could fail or break over time, especially if they are subjected to excessive stress or load. This could necessitate additional surgery to repair or replace the hardware.

3. Pain and Discomfort: Some patients report chronic pain or discomfort associated with the presence of hardware. This can be due to irritation of surrounding tissues or the hardware itself being palpable under the skin.

4. Allergic Reactions: In some cases, patients may have allergic reactions to the materials used in the screws or plates, leading to inflammation or other complications.

5. Bone Remodeling Issues: The presence of hardware can sometimes interfere with normal bone remodeling processes. This could potentially lead to issues such as non-union or malunion of the fracture, where the bone does not heal properly.

6. Nerve Damage: As your doctor mentioned, there is a risk of nerve damage if the hardware is removed. This is particularly a concern in areas where nerves are closely associated with the bone structure.


Long-term Considerations
Leaving the hardware in place can often be a safe option, especially if the fracture has healed well and there are no signs of complications. Many patients live with retained hardware without any significant issues. However, it is essential to have regular follow-ups with your orthopedic surgeon to monitor the condition of the hardware and the healing of the bone.


Potential Long-term Effects
1. Chronic Pain: Some patients may experience chronic pain in the area where the hardware is located, which may require management through physical therapy or pain management strategies.

2. Reduced Range of Motion: Depending on the location of the hardware, there may be some limitations in the range of motion of the affected limb. This can sometimes be improved with physical therapy.

3. Osteoarthritis: There is a potential risk of developing osteoarthritis in the joint adjacent to the hardware, particularly if the hardware affects the normal biomechanics of the joint.

4. Need for Future Surgery: While many patients do well with retained hardware, there is always the possibility that future complications may arise, necessitating surgical intervention to remove the hardware.


Conclusion
In summary, while there are risks associated with both leaving and removing bone screws and plates, many patients can safely retain their hardware without significant long-term complications. It is crucial to weigh the risks and benefits with your orthopedic surgeon, considering your specific circumstances, the nature of your fracture, and your overall health. Regular monitoring and follow-up care are essential to ensure that any potential issues are addressed promptly. If you experience any new symptoms or changes in your condition, be sure to consult your healthcare provider for further evaluation.