Should You Remove Steel Plates and Screws After Fracture Surgery? - Orthopedics

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When it comes to the question of whether to remove steel plates and screws after fracture surgery, there are several factors to consider. The decision to remove hardware, such as plates and screws, is typically based on individual circumstances, including the patient's healing progress, the presence of symptoms, and the potential risks involved.

In your case, it sounds like you experienced a severe open fracture that required extensive surgical intervention, including the placement of 15 steel pins. The fact that your X-rays show good bone healing is a positive sign, but the presence of a crack in the main bone near the ankle and ongoing pain during movement raises concerns that need to be addressed.


Understanding the Relationship Between Hardware and Joint Pain
1. Joint Pain and Inflammation: It is not uncommon for patients with orthopedic hardware to experience discomfort or pain in the area surrounding the hardware. This can sometimes be attributed to the hardware itself, especially if it is in close proximity to joints or if it is causing irritation to surrounding tissues. In your case, the doctor mentioned that the pain is related to joint inflammation rather than the bone itself. This suggests that the hardware may not be the direct cause of your pain, but it could still be contributing to discomfort.

2. Hardware Removal Considerations: The decision to remove hardware is often influenced by several factors:
- Symptom Severity: If the hardware is causing significant pain or functional limitations, removal may be considered.

- Bone Healing: If the bone has healed adequately and is stable, the surgeon may feel more comfortable removing the hardware. However, if there are concerns about the integrity of the bone, as in your case with the crack, the surgeon may advise against removal.

- Risk of Complications: Removing hardware can sometimes lead to complications, such as infection or re-fracture, especially if the bone is not fully healed. Your surgeon's advice to keep the hardware in place to avoid creating a void in the bone is a valid concern.

3. Long-Term Considerations: If you choose to keep the hardware, it is essential to maintain regular follow-ups with your orthopedic surgeon to monitor your healing and any ongoing symptoms. If the pain persists or worsens, further imaging or evaluations may be necessary to assess the situation.


Recommendations
- Consultation with Your Surgeon: It is crucial to have an open and honest discussion with your orthopedic surgeon about your symptoms, concerns, and the potential benefits and risks of hardware removal. If you feel uncertain, seeking a second opinion from another orthopedic specialist may provide additional insights.


- Physical Therapy: Engaging in physical therapy may help alleviate some of the discomfort associated with joint inflammation and improve your overall mobility. A physical therapist can provide exercises tailored to your condition and help strengthen the muscles around the joint.

- Pain Management: Discuss pain management options with your healthcare provider. This may include medications, physical therapy, or alternative therapies that can help manage inflammation and discomfort.

- Monitoring Symptoms: Keep track of your symptoms, including when they occur and their severity. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, the decision to remove steel plates and screws after fracture surgery should be made collaboratively with your orthopedic surgeon, taking into account your specific circumstances, the state of your healing, and your ongoing symptoms. Your health and comfort are paramount, and addressing your concerns with your healthcare provider is the best way to ensure you receive the appropriate care.