Yes, screws and other surgical hardware can be removed after wrist surgery, although it is not always necessary or routinely performed.
Understanding Surgical Hardware Removal from the Wrist
After wrist surgery, particularly for fractures or fusions, orthopaedic surgeons often use internal fixation devices like screws, plates, wires, or pins to stabilize bones and facilitate healing. While this hardware is designed to be left in permanently, there are several reasons why it might be removed.
Reasons for Hardware Removal
The decision to remove surgical hardware is typically based on the patient's symptoms and the surgeon's assessment. Common reasons include:
- Pain or Discomfort: The most frequent reason for removal is localized pain, tenderness, or discomfort caused by the hardware irritating surrounding soft tissues, tendons, or nerves.
- Hardware Prominence: Sometimes, the hardware may be palpable or visually prominent under the skin, leading to discomfort or an aesthetic concern.
- Infection: Although rare, if an infection develops around the hardware, its removal may be necessary to clear the infection.
- Tendinitis or Irritation: The hardware can sometimes rub against tendons, leading to inflammation or tendinitis.
- Hardware Failure: In rare cases, the hardware might loosen, break, or migrate, necessitating its removal.
- Patient Preference: Some patients simply prefer to have the hardware removed once bone healing is complete and the hardware is no longer serving a structural purpose.
The Removal Procedure
Hardware removal is generally a less invasive procedure than the initial surgery. Most commonly, surgeons will re-use the previous incisions that are already on your wrist to access and remove the hardware. This approach helps minimize new scarring and often simplifies the procedure.
- Anesthesia: The procedure can be performed under local, regional, or general anesthesia, depending on the complexity and patient preference.
- Day-Case Procedure: The procedure is most commonly a day-case, meaning you should be able to go home on the same day after a period of recovery from the anesthesia.
- Recovery: Recovery from hardware removal is typically much shorter and less involved than the original surgery. You may experience some localized swelling, bruising, and mild pain, which can be managed with pain medication. Full recovery and return to normal activities usually occur within a few weeks.
When is Hardware Removal Considered?
Hardware is generally left in place until the bone has fully healed and consolidated, which can take anywhere from 6 to 12 months or even longer depending on the initial injury and individual healing process. Removal is not typically performed until the bone has achieved sufficient stability, ensuring the structural integrity of the wrist is not compromised.
The decision for hardware removal is always a discussion between the patient and their orthopedic surgeon, weighing the potential benefits against the risks of a second surgical procedure.
