Bone Healing: When to Remove Cast After Surgery

Bone fracture

After the removal of the ulnar plate, the doctor did not initially apply a cast for stabilization, and only added one upon request.
When the stitches were removed, the doctor indicated that stabilization was no longer necessary; however, he mentioned that the screw holes would take two to three months to heal.
I wonder why he didn't recommend additional stabilization for a few more weeks, which has led to my current situation.
The screw holes in the bone are healing very slowly, and within a month, I accidentally injured the area again, causing a crack next to the screw hole.
I did not undergo another surgery, but instead, a long arm cast was applied.
The doctor stated that after six weeks, the cast could be removed or changed to a short arm cast depending on the situation.

Is it sufficient to remove the cast once the fracture site has healed, or is it better to wait until the screw holes have healed before removing the cast? Thank you for your response, as I am feeling quite frustrated and disheartened.

A Jie, 30~39 year old female. Ask Date: 2007/01/23

Dr. Shi Guozheng reply Orthopedics

After the healing of a ulnar fracture and the removal of the plates and screws, it is important to be cautious to avoid re-injury, as the bone's strength may be somewhat compromised compared to normal.
Typically, the screw holes take about three months to six months to heal completely.
Generally, there is no need for additional protection with a cast, as long as the patient takes care to protect the area themselves.
If a re-fracture occurs, the current approach by the physician is appropriate; a cast should be applied until the fracture site has healed, at which point the cast can be removed.

Reply Date: 2007/01/23

More Info

When it comes to bone healing and the removal of casts after surgery, there are several important factors to consider. The healing process of bones is complex and can vary significantly depending on the type of fracture, the surgical intervention, and the individual’s overall health.
In your case, it seems that you have undergone surgery to fixate a fracture with a plate and screws, and you are experiencing some complications related to the healing of the screw holes. The general principle is that a cast or splint is used to immobilize the area to promote healing and prevent further injury. However, the duration for which a cast is needed can vary based on several factors, including the stability of the fracture, the type of fixation used, and the presence of any complications.

Typically, after surgery, the initial healing phase lasts about 6 to 8 weeks, during which the bone begins to form a callus around the fracture site. The screw holes, which are created during the surgical procedure, can take longer to heal, often requiring several weeks to months for complete healing. This is because the bone needs to regenerate and fill in the gaps left by the screws. If the screws are removed too early, or if the area is subjected to stress before it is fully healed, it can lead to complications such as further fractures or delayed healing.

In your situation, it is crucial to follow your surgeon's recommendations regarding immobilization. If your doctor has advised that the cast can be removed after six weeks, it is likely based on their assessment of your healing progress. However, if you have concerns about the healing of the screw holes, it is essential to communicate this with your healthcare provider. They may recommend additional imaging, such as an X-ray, to assess the status of the bone healing before making a decision about cast removal.

Regarding your question about whether the cast should remain until the screw holes heal, it is generally advisable to keep the cast on until the fracture site is stable and there is no risk of further injury. If the fracture site is stable and the doctor believes that the risk of re-injury is low, they may allow for the removal of the cast. However, if there is any doubt about the stability of the fracture or the healing of the screw holes, it may be prudent to keep the cast on for a longer period.

In summary, the decision to remove a cast after surgery should be based on a thorough evaluation of the healing process. It is essential to maintain open communication with your healthcare provider and express any concerns you may have about your recovery. They can provide you with the best guidance tailored to your specific situation. Remember that patience is key in the healing process, and following your doctor's advice will help ensure the best possible outcome for your recovery.

Similar Q&A

Post-Fracture Recovery: Ensuring Bone Healing and Managing Discomfort

Hello Doctor, I would like to inquire about my condition. I underwent an open reduction and internal fixation surgery on my left humerus on August 6th, and had the cast removed on September 21st after nearly 7 weeks of immobilization. Following the cast removal, I attended rehabi...

Dr. Chen Bochen reply Orthopedics
Hello, Miss Chang. I would like to inquire about my situation. I underwent an open reduction and internal fixation surgery on my left humerus on August 6, and I had my cast removed on September 21 after nearly 7 weeks of immobilization. After the cast was removed, I attended reha...

Post-Cast Rehabilitation: Addressing Concerns After Cast Removal

After being in a full cast for three weeks and a half cast for two weeks, I just started moving again. I noticed blood stains, bandage marks, and bruising after the cast was removed. Is this too tight? What negative effects could this have? It feels a bit strange when walking, as...

Dr. Wang Shouji reply Orthopedics
Hello: Generally speaking, if a cast is too tight, it can cause severe pain. After the cast is removed, there may be some discomfort for a while due to incomplete protection. Typically, it takes about two to three weeks to gradually adjust, after which the healing status of the f...

Understanding Distal Radius Fractures: Treatment and Recovery Insights

Hello, doctor. I went to the hospital due to a distal radius fracture from a fall. The doctor said I have a slight comminuted fracture and underwent surgery with titanium alloy fixation. Two weeks after the surgery, I returned for a follow-up, but the doctor did not take any X-ra...

Dr. Chen Yongxue reply Orthopedics
Hello, please trust your attending physician. They are the ones who performed the surgery and know your fracture situation best. No one else understands your condition better than your attending physician. Thank you.

Post-Cast Recovery: Addressing Concerns After Fibula Fracture Surgery

Dear Consultation Team, I have a fracture and dislocation near the joint of my right fibula. On July 20, I underwent a surgical procedure to fixate the bone with screws and was placed in a cast. The cast was removed six weeks later on August 30, 2019. According to my attending p...

Dr. Zhan Xian reply Orthopedics
After removing the cast, walking should be gradually increased and not done excessively at once. If there is slight swelling, elevate the limb and rest. If pain and swelling do not improve, consider returning to the original clinic for follow-up.