Should You Remove Screws After Finger Fracture Surgery? Risks and Concerns - Orthopedics

More Info

---

When it comes to the decision of whether to remove screws after finger fracture surgery, there are several factors to consider, including the nature of the injury, the healing process, and potential long-term effects. In your case, you experienced a spiral fracture of the right index finger, which required surgical intervention and the placement of six screws for stabilization.
Firstly, it is essential to understand that the primary purpose of these screws is to provide stability to the fractured bone during the healing process. Once the bone has healed adequately, the screws may no longer be necessary. However, the decision to remove them is not straightforward and should be based on individual circumstances.

Risks of Leaving the Screws In:
1. Potential for Discomfort: Some patients report discomfort or pain at the site of the screws, especially during physical activities. This discomfort can sometimes be attributed to the screws irritating surrounding soft tissues, including tendons and ligaments.

2. Risk of Migration or Breakage: Although rare, screws can sometimes migrate or break. If a screw breaks, it may require surgical intervention to remove the fragments, especially if they cause pain or impede function.

3. Long-term Effects: While most patients do not experience significant long-term issues from retained screws, there is a possibility of developing complications such as arthritis in the joint adjacent to the fracture site due to altered biomechanics.

Benefits of Removal:
1. Reduced Risk of Complications: Removing the screws can eliminate the risk of irritation to surrounding tissues and potential complications associated with retained hardware.

2. Improved Functionality: Some patients find that their range of motion and overall functionality improves after the removal of screws, especially if they were experiencing discomfort during activities.

Considerations for Removal:
1. Timing: As your physician mentioned, it is often recommended to wait at least a year after surgery before considering removal. This allows sufficient time for the bone to heal completely.

2. Surgical Risks: The removal process itself involves surgery, which carries risks such as infection, nerve damage, and complications related to anesthesia. Additionally, there is a recovery period post-removal that may involve rehabilitation.

3. Individual Assessment: Each case is unique. Factors such as your age, activity level, and the specific nature of your fracture will influence the decision. Consulting with your orthopedic surgeon is crucial to assess whether the benefits of removal outweigh the risks in your specific situation.

Conclusion:
In summary, while it is generally safe to leave screws in place if they are not causing any issues, their removal can be beneficial in certain cases, particularly if they are causing discomfort or if there is a risk of complications. It is essential to have a thorough discussion with your orthopedic surgeon, who can evaluate your specific circumstances, review your healing progress, and help you make an informed decision. Regular follow-ups and imaging studies can also provide insights into the condition of the screws and the healing of your bone, guiding the decision-making process effectively.