Should You Remove Metal Plates After Severe Leg Fractures?

Should it be removed?

Hello, doctor.
Three years ago, I suffered a comminuted open fracture of my left thigh due to a car accident.
At that time, two steel plates were inserted, and follow-up examinations showed that the bone healed well.
The doctor mentioned that the plates could be removed or left in place.
I actually don't plan to have surgery, but recently I want to learn how to ski.
I would like to ask if a severe fracture occurs in the same area without removing the plates, would it be more serious in comparison?

Ke, 30~39 year old female. Ask Date: 2017/10/12

Dr. Li Yongheng reply Orthopedics

Hello, your left femur fracture has healed.
If you do not experience any discomfort in your daily life, it is generally not recommended to undergo surgery to remove the hardware.
Especially since you are considering learning to ski, it is even less advisable to have another surgery to remove the screws at this time.
This is because the holes left by the screws typically take 3 to 6 months to heal.
If a fall occurs before the screw holes have healed, there is a risk of fracturing at those sites.
This advice is for your consideration.
Thank you.

Reply Date: 2017/10/12

More Info

When it comes to the question of whether to remove metal plates after severe leg fractures, particularly in the context of your previous experience with a complex open fracture, there are several factors to consider.
First, it’s important to understand that metal plates and screws are often used in orthopedic surgery to stabilize fractures and allow for proper healing. In your case, the plates were placed three years ago, and your follow-up assessments have indicated that the bone has healed well. This is a positive sign, as it suggests that the hardware is functioning as intended.

Regarding the decision to remove the plates, it is not uncommon for orthopedic surgeons to have differing opinions on this matter. Some surgeons recommend removing the hardware after the bone has healed, especially if it causes discomfort or if the patient is engaging in high-impact activities, such as skiing. Others may advise leaving the hardware in place, particularly if it is not causing any issues. The rationale for removal often includes concerns about potential complications, such as hardware irritation, infection, or the risk of future fractures at the site of the hardware.

Now, addressing your specific concern about the possibility of sustaining another severe fracture in the same area while the plates are still in place: if you were to experience another significant injury to the same leg, the presence of the metal plates could potentially complicate the situation. In some cases, the hardware may provide additional stability and support during the healing process. However, if a new fracture were to occur, it could lead to more complex surgical considerations, including the need to remove the existing hardware to properly address the new injury.

Moreover, the risk of complications such as nonunion (where the bone does not heal properly) or malunion (where the bone heals incorrectly) could be higher if the fracture occurs in close proximity to the existing hardware. This is particularly true in cases of severe fractures, where the integrity of the surrounding bone and soft tissue is compromised.

In terms of your plans to engage in skiing, it is essential to weigh the risks involved. Skiing is a high-impact sport that can put significant stress on the legs and increase the likelihood of falls and injuries. If you choose to ski, it may be wise to consult with your orthopedic surgeon beforehand. They can provide personalized advice based on your specific medical history, the condition of your leg, and the presence of the metal plates.

Additionally, if you experience any discomfort or unusual symptoms related to the hardware, such as pain, swelling, or changes in mobility, it is crucial to seek medical attention promptly. Regular follow-ups with your orthopedic specialist can help monitor the condition of your leg and the hardware, ensuring that any potential issues are addressed early on.

In conclusion, whether to remove metal plates after severe leg fractures is a decision that should be made in consultation with your orthopedic surgeon, taking into account your individual circumstances, activity level, and any potential risks associated with leaving the hardware in place. Engaging in high-impact activities like skiing may require additional consideration and possibly a thorough evaluation of your leg's condition before proceeding. Always prioritize your safety and well-being when making decisions about your health and physical activities.

Similar Q&A

Should Steel Plates Be Removed After Fracture Surgery? Expert Insights

Hello Dr. Li: My daughter had a car accident five years ago that resulted in fractures in both thighs, which were surgically repaired with plates and screws (one row of screws on each side). Now she is considering surgery to remove the plates. The original surgeon informed us tha...

Dr. Li Wenlin reply Orthopedics
Hello: In response to your question, I personally recommend removing the plate for your daughter for two reasons: First, she is still young, and if the cobalt-chromium alloy plate remains in the body for too long, there may be concerns about material degradation (although there a...

Understanding Pain After Removing Metal Plates and Screws from Leg Fracture

I was in a car accident at the end of last year, and my calf was fractured. After surgery, I had metal plates and screws inserted. Last week, on December 6, the plates and screws were removed. I was discharged three days later, and for a few days, the wound didn't hurt much....

Dr. Wang Shouji reply Orthopedics
Hello, even if the wound is covered with cosmetic adhesive, you can gauge its condition by whether it continues to ooze blood. If, after resting, it does not heal and remains painful, it is advisable to return for a check-up. Changhua Hospital cares about your health. Sincerely, ...

Post-Surgery Care: Do You Need Crutches After Removing Metal Plates?

Hello, I sustained a displaced and comminuted fracture of the right tibial plateau due to a car accident and underwent an open reduction and internal fixation surgery with plates and screws. If I decide to have the hardware removed, will I still need to use crutches postoperative...

Dr. Li Yongheng reply Orthopedics
Hello: Generally, the metal pins and plates are removed only after the fracture has completely healed. Therefore, postoperatively, crutches are usually not needed; or crutches may be used for 2 weeks, until the stitches are removed, after which crutches are no longer necessary.

Challenges of Removing Long-Term Orthopedic Hardware After 27 Years

Hello Doctor: I suffered an open fracture of my right thigh in 1995. A year after the surgery, I intended to have the steel plate and screws removed, but the doctor advised that it was unnecessary and I could live normally without removal. Now, 27 years later, I experienced sudde...

Dr. Shi Guozheng reply Orthopedics
If the metal plate has fractured, it is important to check for any associated bone fractures. If there are no fractures, the metal plate can simply be removed. However, if there is a fracture, a second surgery will be necessary to stabilize the bone.