Concerns After Ankle Surgery: What to Do About a Broken Screw?

During the ankle surgery to remove the metal screw, the head of the screw broke off, making it difficult to extract. I am feeling very anxious about this situation?

Hello Doctor, on December 25, 2014, I fractured my ankle and underwent surgery to have three metal screws inserted.
A year later, at the end of December 2015, the doctor said I could have them removed, but I decided to wait until after the New Year.
During the surgery, the doctor made a large incision but only removed two screws; the head of the last screw broke off, and the doctor was unable to remove it and did not want to attempt it again.
Eventually, I was told that it was actually fine to leave it in.
However, I have seen that the screw is quite long, and I am concerned that the broken screw could potentially cause various health issues or discomfort.
What should I do next, aside from waiting for healing, to ensure that my ankle does not have any long-term complications? Thank you.

Wen Zi, 40~49 year old female. Ask Date: 2016/03/09

Dr. Shi Guozheng reply Orthopedics

Patients with metal implants, such as those with artificial joints, typically do not experience significant adverse effects from having metal in their bodies.
Generally, these individuals do not suffer from long-term complications.

Reply Date: 2016/03/09

More Info

After undergoing ankle surgery, particularly one involving the insertion of screws or pins, it is not uncommon to have concerns about the presence of hardware, especially if a piece has broken or remains embedded in the body. In your case, it seems that one of the screws could not be removed due to it breaking during the extraction process. Here are some insights and recommendations regarding your situation.

Understanding the Situation
1. Hardware in the Body: It is important to understand that orthopedic hardware, such as screws and plates, is designed to be biocompatible, meaning it should not cause adverse reactions in the body. Many patients live with retained hardware without any issues. However, concerns about broken screws are valid, as they can potentially lead to complications if they migrate or cause irritation to surrounding tissues.

2. Potential Risks: A broken screw can lead to several issues, including:
- Infection: If the broken piece is exposed or if there is a wound, there is a risk of infection.

- Pain or Discomfort: The presence of hardware can sometimes cause discomfort, especially if it irritates surrounding tissues.

- Nonunion or Malunion: If the hardware is meant to stabilize a fracture, any issues with the hardware can affect the healing process.

3. Consultation with Your Surgeon: It is crucial to maintain open communication with your orthopedic surgeon. If you have concerns about the broken screw, you should discuss these with your doctor. They may recommend imaging studies, such as X-rays or MRIs, to assess the situation further.

Recommendations for Post-Surgery Care
1. Follow-Up Appointments: Ensure you attend all scheduled follow-up appointments with your orthopedic surgeon. These visits are essential for monitoring your healing process and addressing any concerns you may have.

2. Physical Therapy: Engaging in physical therapy can be beneficial for regaining strength and mobility in your ankle. A physical therapist can provide tailored exercises to help you recover and minimize the risk of complications.

3. Monitoring Symptoms: Keep an eye on any symptoms that may arise, such as increased pain, swelling, redness, or warmth around the surgical site. If you notice any of these signs, contact your healthcare provider immediately.

4. Lifestyle Adjustments: Depending on your recovery stage, you may need to modify your activities. Avoid high-impact activities until your doctor gives you the green light. Gradually increase your activity level as advised by your healthcare team.

5. Pain Management: If you experience pain, discuss pain management options with your doctor. They may recommend over-the-counter pain relievers or prescribe medications if necessary.

6. Nutrition and Hydration: Maintaining a balanced diet and staying hydrated can support your healing process. Nutrients such as protein, vitamin C, and zinc are particularly important for tissue repair.

7. Consider a Second Opinion: If you are still concerned about the broken screw and the advice you received, seeking a second opinion from another orthopedic specialist can provide additional insights and peace of mind.

Conclusion
While it is understandable to be concerned about a broken screw after ankle surgery, many patients manage well with retained hardware. The key is to stay proactive about your health by maintaining regular communication with your healthcare providers, adhering to follow-up appointments, and monitoring your recovery closely. If you have persistent concerns, do not hesitate to seek further evaluation or a second opinion. Your health and peace of mind are paramount, and addressing these issues head-on will help ensure a smoother recovery process.

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