When a Screw Comes Loose

Why do you think the lady imaged below cannot get her shoe to fit anymore ?

And yes, she truly does have a “screw loose” 😜 She presented with the screw head almost pushing through the skin as you can see in the image with the yellow arrow.

The patient had surgery about 15 years ago by another doctor and the screw is just slowly working its way out of the bone. We will have to take that out! 😷