pain and swelling after titanium staple broke in my foot

Hello! Last year I had an Austin Bunionectomy on my right foot. The surgeon used a staple which I was told is made of titanium. Surgery and recovery went well. I recently had the same procedure done on my left foot and approximately 3 weeks post surgery I felt a popping sensation in my foot and this was followed by an increase in both pain and swelling. Xrays revealed that the end of the staple had broken and the bones were not healing properly together. I am now wearing an ankle boot to stabilize the foot in hopes that it will heal. My doctor said that he has never had any of these staples break in a patient. He is a foot and ankle specialist and well respected in his field. Have you ever experienced this in your practice? Do you have any idea if the broken staple could eventually work its way out of the bone and up thru tissue in my foot to cause additional problems? Will the bones heal back together by immobilization only, wearing the boot? I do return soon for additional xrays of the foot to check on my progress.

RESPONSE

Hi,

Potential complications are a part of every type of surgery; that is one of the risks people take when they consent to surgery. I do not use titanium staples but I too, over the years, have had fixation devices that either broke or did not "hold" the bones together.
The pain and swelling that you are experiencing is more from the fact that your surgically derived broken bone is now not properly aligned, more so than from the broken staple.
If you search around this web site using our custom Google search box, you will see numerous stories about people who have had similar experiences.
It happens and a good surgeon needs to know what to do.
You mention in your narrative that the bone alignment is not good. The bigger the gap between the two ends of the bone, the less likely they will heal with immobilization via a cast boot. Of course, I am not privy to your x-rays so I cannot comment specifically what will happen in your case.
Apparently, though, you doctor has determined that with immobilization there is a fair chance the bone could heal and if that is the case then you are done, almost.
There is also the issue of the broken staple. If both ends of the staple are embedded in bone, then there is a fair chance neither end will move and that lessens the possibility that they will be an issue.
The only other consideration would be if the angle of the broken staple is such that it is irritating the soft tissue around the bone, then perhaps it could become a point of contention.
Unless absolutely necessary most surgeons do not want to have to re-operate on a patient.
If your doctor has a good reputation and you trust him, then go with his advice.
Go through the period of immobilization and see how you end up. If he is able to get the bone to mend and the broken staple is not an issue, then he has saved you a lot of aggravation. If the bone does not properly heal or the broken staple is annoying to you, then you are probably looking at a second surgery.
If you have any qualms about your situation, get a second opinion from another foot specialist in your area.

Marc Mitnick DPM
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