Challenges After Surgery: What to Do When a Broken Screw Remains

The removal surgery for the steel nail was unsuccessful, resulting in the breakage of the nail head, and the remaining portion could not be extracted?

Hello, Doctor.
In December of the year before last, I fractured my ankle and underwent surgery where three metal screws were inserted.
In December of last year, the doctor said they could be removed, but I wanted to wait until after the New Year.
After several instances of walking, my foot was very painful.
When I underwent surgery after the New Year, the doctor made a very large incision and only removed two screws; the head of the last screw broke off, and the remaining part could not be extracted.
I have seen that the screw is quite long, and I am worried it might pierce the skin if there is another accident.
Aside from waiting for healing, what should I do to ensure that my foot does not have any long-term complications? Thank you.

Annie, 40~49 year old female. Ask Date: 2016/03/11

Dr. Chen Yongxue reply Orthopedics

Hello, it is not uncommon for a steel pin to break.
In such cases, the pin is often unable to be completely removed and may remain embedded in the bone.
There is no need to worry about it piercing the skin, but it is important to check for any other issues, such as whether it has entered a joint.
Please visit an orthopedic clinic for further evaluation.
Thank you.

Reply Date: 2016/03/11

More Info

After experiencing a broken ankle and undergoing surgery to insert three screws, it is understandable that you are concerned about the remaining broken screw and the potential complications it may cause. Here’s a comprehensive overview of the challenges you might face and the steps you can take to ensure a smooth recovery.

Understanding the Situation
When a screw breaks during removal, it can lead to several concerns. The most immediate worry is whether the remaining portion of the screw could cause pain or complications, such as piercing the skin or causing irritation to surrounding tissues. However, it’s important to note that the risk of a screw piercing the skin is relatively low, especially if the screw is embedded within the bone and not protruding outward.

Healing Process
1. Waiting for Healing: The first step is to allow your body to heal. Bone healing can take several weeks to months, depending on the severity of the fracture and your overall health. During this time, it’s crucial to follow your doctor’s advice regarding weight-bearing activities and rehabilitation exercises.

2. Monitoring Symptoms: Keep an eye on any symptoms that may arise, such as increased pain, swelling, or redness around the surgical site. If you experience any of these symptoms, it’s essential to contact your healthcare provider promptly.

3. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can guide you through exercises that strengthen the ankle and improve its range of motion, which is vital for recovery. They can also help you manage any discomfort associated with the remaining screw.

Preventing Complications
1. Follow-Up Appointments: Regular follow-ups with your orthopedic surgeon are crucial. They can monitor the healing process through X-rays and assess whether the remaining screw poses any risks. If complications arise, they may recommend further intervention.

2. Pain Management: If you experience pain, discuss pain management options with your doctor. This may include over-the-counter pain relievers or prescribed medications. Additionally, ice therapy and elevation can help reduce swelling and discomfort.

3. Activity Modification: Modify your activities to avoid putting undue stress on your ankle. Gradually increase your activity level as advised by your healthcare provider. Avoid high-impact activities until you receive clearance.

Surgical Considerations
If the remaining screw becomes problematic, your doctor may discuss the possibility of a second surgery to remove it. This decision will depend on various factors, including your pain levels, the screw’s position, and the overall healing of your ankle.

Emotional and Psychological Support
Dealing with a prolonged recovery can be frustrating and emotionally taxing. It’s essential to seek support from friends, family, or even professional counseling if you feel overwhelmed. Connecting with others who have undergone similar experiences can also provide comfort and insight.

Conclusion
In summary, while having a broken screw remaining in your ankle can be concerning, many patients successfully navigate this situation with proper care and monitoring. Focus on healing, adhere to your rehabilitation plan, and maintain open communication with your healthcare team. Should any complications arise, your doctor will guide you on the best course of action. Remember, patience is key in the recovery process, and taking proactive steps will help ensure the best possible outcome for your ankle health.

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