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The response to the question below was authored by Marc Mitnick DPM

Retained broken off pin in 2nd toe

by Sharon
(SC)

I had an osteotomy 13 weeks ago at the base of my 2nd toe in the left foot along with excision of a neuroma. At the same time I elected to have a right bunionectomy with 2nd toe resection. At the 6 week post op visit the pins were removed from the 2nd toes and the left one broke off. Xrays show it to be encapsulated by the bone (not in the joint). Now 7 weeks later the right foot with the extensive work is great but the left one hurts at the base of the 2nd toe. The surgeon said it was inflammation but it is swollen more than the other one and much more painful. I have started back on my Mobic with no change. I do not fault the surgeon. I just want to know if it's usually requiring another surgery to remove it? Thank you


RESPONSE

Hi Sharon,

Broken hardware is a complication of orthopedic surgery. It has happened to me and it probably has happened to anyone who performs this type of surgery.

The general rule is that broken hardware can stay implanted as long as it does not end up being an irritant or somehow affect function, in this case, the second toe.

I am only guessing here since I am not privy to x-rays, my first thought is that there might be inflammation being produced from the encapsulation of the wire. Since it is a foreign body, your body may be responding to it. Whether or not this will calm down remains to be seen.

I am not really clear if you are thirteen weeks post op or twenty weeks post op based on your narrative. If your surgeon is absolutely sure the pin does not extend into the base, you could wait a while longer and see if the problem calms down and resolves itself.

If the condition does not resolve itself, then the smart money would be on having the pin removed. Whether this ends up being a simple procedure or more complicated depends on how long a piece of the pin is still in your toe and how far away it is from the joint. The joint would be the simplest way to access the second toe to get to the k-wire.

It comes down to this. If you trust your surgeon then follow his or her's advice. If you find that the surgeon does not appear to be working in your best interest, then a second opinion by another surgeon in your area would be indicated.

Marc Mitnick DPM
DISCLAIMER


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Apr 10, 2016
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by: Anonymous

Thank you for your response Dr. Mitnick. It is greatly appreciated. I do trust my surgeon and I feel less concern now that there doesn't seem to be an urgency to remove it. It is not very close to the joint and it's about 0.5cm long. I will give it more time.

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Columbia University Department of Rehabilitation

ScienceDirect

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Illinois Bone and Joint Institute

Mount Sinai Hospital

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University of Florida Health

American Family Physician

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Wonderful advice

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location unknown
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