Managing Post-Surgery Pain After Metal Plate Removal in Orthopedics

Postoperative soreness?

Hello Doctor: I fractured my left fibula while skateboarding in June of the year before last.
At that time, I had a steel rod inserted.
Although I was told that I could have it removed after a year, I delayed the removal due to my busy work schedule, and I just had it taken out today.
My wife mentioned that during my surgery, the doctor came out to explain that the steel rod had been in place for too long and that my bone was almost absorbing it.
The doctor said there were two options: 1.
to break it for removal, or 2.
to leave it in place.
However, the doctor made every effort to remove the rod.
I would like to ask if there is a possibility of developing bone spurs after the removal, and I am experiencing significant discomfort in my foot post-surgery.
I have heard that after the removal of the steel rod, one can walk immediately (though it may be painful), but I am experiencing such soreness that I cannot stand upright at all, and I clearly need a walker.
What methods can help alleviate the soreness?

lun, 20~29 year old female. Ask Date: 2016/02/23

Dr. Hong Ximing reply Orthopedics

Removal of the steel pins after a fibula fracture indicates that the fracture has healed.
However, it is safer to protect the area for an additional four weeks after the removal.
As for postoperative pain, it should resolve quickly once the wound has healed.

Reply Date: 2016/02/23

More Info

Managing post-surgery pain after metal plate or screw removal in orthopedics can be a complex process, especially when the patient has experienced prolonged discomfort or complications related to the hardware. In your case, it seems that the removal of the screw from your fibula has led to significant discomfort, which is not uncommon. Here’s a comprehensive overview of what you might expect and some strategies to manage your pain effectively.

Understanding Post-Surgery Pain
After the removal of orthopedic hardware, such as screws or plates, it is normal to experience pain and discomfort. This can be attributed to several factors:
1. Soft Tissue Trauma: The surgical procedure itself can cause trauma to the surrounding soft tissues, including muscles, tendons, and ligaments. This trauma can lead to inflammation and pain post-surgery.

2. Bone Healing: If the hardware was in place for an extended period, the bone may have adapted to its presence. The sudden removal can lead to a temporary imbalance as the bone and surrounding tissues adjust.

3. Nerve Sensitivity: The surgery may have affected nearby nerves, leading to heightened sensitivity or pain in the area. This is often referred to as neuropathic pain.

4. Scar Tissue Formation: Surgery can lead to the formation of scar tissue, which may contribute to discomfort and limit mobility.

Managing Pain After Hardware Removal
Here are some strategies to help manage your pain effectively:
1. Pain Medication: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. If your pain is severe, your doctor may prescribe stronger pain medications.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can guide you through exercises designed to improve mobility, strengthen the affected area, and alleviate pain. They can also provide modalities like ultrasound or electrical stimulation to help with pain relief.

3. Rest and Elevation: Allowing your leg to rest and keeping it elevated can help reduce swelling and discomfort. Avoid putting weight on the leg until you feel comfortable doing so.

4. Ice Therapy: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce swelling and numb the pain.

5. Gradual Weight Bearing: While some people may be able to walk shortly after hardware removal, it’s essential to listen to your body. If you’re experiencing significant pain, it may be wise to use a walker or crutches until you can bear weight comfortably.

6. Gradual Return to Activity: Start with gentle range-of-motion exercises as tolerated. Gradually increase the intensity and duration of your activities as your pain decreases and your strength improves.

7. Follow-Up Care: Regular follow-up appointments with your orthopedic surgeon are crucial. They can monitor your healing process and address any complications, such as the formation of bone spurs or other issues.

Potential Complications
Regarding your concern about bone spurs (osteophytes) after screw removal, it is possible for bone spurs to develop, especially if there was pre-existing joint degeneration or if the bone was under stress during the healing process. However, not everyone will experience this, and it often depends on individual factors such as age, activity level, and the extent of the initial injury.

Conclusion
In summary, while it is common to experience discomfort after the removal of orthopedic hardware, there are several strategies you can employ to manage your pain effectively. It’s essential to communicate openly with your healthcare provider about your symptoms and concerns, as they can tailor a management plan specific to your needs. With time, appropriate care, and rehabilitation, many patients find significant relief and can return to their normal activities.

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