Do I Need to Remove My Mother's Radial Bone Plate After Surgery?

Radial bone issues

Hello Doctor, my mother is nearly 60 years old.
Last year, she underwent treatment for a fracture of the left radius.
The surgeon recommended two types of fixation plates (one covered by insurance and one out-of-pocket).
We chose the out-of-pocket fixation plate, and her recovery has been good so far, with no major issues.
However, I remember hearing that the fixation plate needs to be removed one year after surgery, but my mother mentioned that mostly the insurance-covered ones need to be removed, while the out-of-pocket ones do not.
I am still concerned that something that should be removed has not been taken out, and the receipt did not clearly indicate which type of fixation plate was used.
I only know it was out-of-pocket, so I would like to ask the doctor how I can determine if my mother needs another surgery to remove the fixation plate.
Thank you, Doctor.

kamoko, 50~59 year old female. Ask Date: 2018/05/18

Dr. Shi Guozheng reply Orthopedics

The question of whether to remove the steel plate after surgery for a radius fracture is often asked.
The principle is that if it does not affect hand function and there is no discomfort, the plate and screws can remain in place.
Sometimes, there may be issues with tendons getting caught or inflammation occurring in the forearm near the wrist.
These are risks to consider; if none of these conditions are present, removal is not necessary.
This decision is unrelated to whether the materials are covered by health insurance.
If removal of the plate is needed, it should only be done after the bone has completely healed, which usually takes over a year, to avoid the risk of re-fracture.
Additionally, removing the plate requires another surgery, which necessitates a hospital stay of several days and subsequent recovery.

Reply Date: 2018/05/18

More Info

When considering whether to remove a radial bone plate after surgery, several factors must be taken into account. Your mother's situation, including her age, the type of plate used, and her overall recovery, plays a crucial role in determining the necessity of plate removal.

Firstly, it is essential to understand that the decision to remove a bone plate is not solely based on the type of plate (whether it is covered by insurance or self-paid) but rather on the clinical situation of the patient. In many cases, plates are left in place if they are not causing any issues, such as pain, discomfort, or complications like infection or irritation. If your mother has been recovering well without any significant problems, it may not be necessary to remove the plate.

Typically, bone plates are designed to remain in the body permanently unless they cause problems. In some cases, surgeons may recommend removal after a certain period, often around one year post-surgery, especially if the bone has healed adequately and the plate is no longer needed for stability. However, this recommendation can vary based on individual circumstances, including the patient's age, activity level, and the specific nature of the fracture.

Regarding your concern about the type of plate used, if the surgeon did not specify that the self-paid plate should be removed, it is likely that it was intended to remain in place. It is also important to note that the presence of a plate does not inherently lead to complications; many patients live with plates without any issues.

To assess whether your mother needs another surgery to remove the plate, consider the following steps:
1. Consult with the Surgeon: The best course of action is to schedule a follow-up appointment with the surgeon who performed the operation. They can evaluate your mother's current condition, review her X-rays, and determine if the plate is still necessary or if it should be removed.

2. Monitor Symptoms: Pay attention to any symptoms your mother may experience, such as persistent pain, swelling, or discomfort around the surgical site. If she experiences any of these symptoms, it is crucial to report them to her healthcare provider.

3. Consider Functional Recovery: If your mother has regained full function of her wrist and hand without pain or limitations, this is a positive sign that the plate may not need to be removed. However, if she is still experiencing issues, further evaluation may be warranted.

4. Understand Risks and Benefits: Discuss the potential risks and benefits of plate removal with the surgeon. While removal can alleviate concerns about future complications, it also involves another surgical procedure, which carries its own risks.

In summary, the decision to remove a radial bone plate should be made based on a thorough evaluation by a healthcare professional. If your mother is doing well and has no significant issues related to the plate, it may not be necessary to remove it. However, consulting with her surgeon will provide the most accurate guidance tailored to her specific situation.

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