Should You Remove Steel Plates After Fracture Surgery? A Skiing Perspective

Plate removal issues

Three years ago, I suffered an open comminuted fracture of the left femur due to a car accident, and two steel plates were inserted at that time.
Follow-up examinations showed that the fracture and bone condition were both good, and the doctor mentioned that the plates could be removed or left in place.
Initially, I did not plan to have them removed, but recently I have been considering learning to ski.
I would like to ask the doctor, in the case of having two steel plates in my left leg, if a fracture were to occur again in the same area, which situation would be worse?

Ke, 30~39 year old female. Ask Date: 2017/10/15

Dr. Li Yongheng reply Orthopedics

Hello, your left femur fracture has healed.
If you are not experiencing any discomfort in your daily activities, it is generally not recommended to undergo another surgery to remove the hardware.
This is especially true considering your recent interest in learning to ski; it is even less advisable to have the screws removed in the near future.
After the removal of the screws, the holes left in the bone typically take 3 to 6 months to heal.
If a fall occurs before the screw holes have healed, there is a risk of fracturing the bone at those sites.
This advice is for your consideration.
Thank you.

Reply Date: 2017/10/15

More Info

When considering whether to remove steel plates after fracture surgery, especially in the context of engaging in high-risk activities like skiing, there are several factors to weigh. Your situation, having sustained a severe open fracture of the left femur three years ago and currently having two steel plates in place, presents a unique set of considerations.

Firstly, it’s important to understand that the primary purpose of the steel plates is to stabilize the bone during the healing process. Once the bone has healed adequately, as confirmed by your follow-up examinations, the plates may not be necessary for continued stability. In many cases, if the plates are not causing discomfort or complications, they can remain in place without any issues.
However, the concern arises when considering the potential for re-injury. If you were to sustain another fracture in the same area where the plates are located, the presence of the plates could complicate the situation. The risk of a more severe injury could be higher due to several factors:
1. Structural Integrity: The steel plates are designed to provide support, but if a new fracture occurs, the plates could potentially limit the natural healing process or lead to complications such as malunion or nonunion of the bone.

2. Increased Risk of Complications: If a fracture occurs at the same site, the presence of the plates could lead to more complex surgical interventions. The plates may need to be removed or adjusted, which could increase the risk of infection, nerve damage, or other complications during surgery.

3. Post-Surgical Recovery: If surgery is required to address a new fracture, the recovery process could be prolonged. The presence of the plates might necessitate additional rehabilitation or a longer period of immobilization, which could impact your ability to return to activities like skiing.

4. Pain and Discomfort: Some individuals experience discomfort or pain at the site of the plates, especially during physical activities. If you are planning to ski, the physical demands of the sport could exacerbate any discomfort associated with the plates.

In light of these considerations, if you are not experiencing any pain or discomfort from the plates, and your doctor has indicated that they can remain in place, it may be advisable to keep them. However, if you are concerned about the risk of re-injury while skiing, it might be worth discussing with your orthopedic surgeon the possibility of removing the plates before engaging in such activities.
Ultimately, the decision should be based on a thorough discussion with your healthcare provider, taking into account your overall health, the condition of your leg, and your plans for skiing. If you decide to keep the plates, ensure that you take appropriate precautions while skiing, such as wearing protective gear and being mindful of your limits to reduce the risk of falls or injuries.

In summary, while the presence of steel plates can provide stability, they may also complicate future injuries. If you are considering skiing, weigh the risks and benefits of keeping the plates versus removing them, and consult with your orthopedic specialist to make an informed decision that prioritizes your health and safety.

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