Should You Remove Plates After Proximal Humerus Fracture Surgery? - Orthopedics

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After a proximal humerus fracture surgery, the decision to remove the plates and screws is a nuanced one that depends on several factors, including the patient's recovery, the presence of any complications, and the potential impact on daily life. In your case, since you have had a good recovery with no nerve damage and are actively engaging in rehabilitation, it is important to weigh the benefits and risks of removing the hardware.

Generally, plates and screws used in fracture fixation are designed to remain in place unless they cause problems. Many patients live with these implants without any issues. However, if you are experiencing discomfort or limitations in range of motion, as you mentioned, it may be worth discussing the option of removal with your orthopedic surgeon.
The primary considerations for removing the hardware include:
1. Functional Limitations: If the presence of the plate is significantly affecting your range of motion or causing discomfort, it may be justified to consider removal. However, it is important to note that removing the plate does not always guarantee an improvement in motion or pain relief. Some studies suggest that the removal of plates does not significantly enhance shoulder function in all patients.

2. Risk of Nerve Injury: One of the concerns with removing plates, particularly in the shoulder region, is the risk of damaging nearby nerves, such as the axillary nerve. This nerve is responsible for sensation over the lateral aspect of the shoulder and innervates the deltoid muscle. If the nerve is inadvertently injured during the removal process, it could lead to complications such as weakness or numbness.

3. Timing of Removal: The timing of hardware removal can also play a role. Typically, if the bone has healed well and the hardware is no longer necessary for stability, removal is considered. This is often done at least 6-12 months after the initial surgery, allowing sufficient time for the bone to heal adequately.

4. Surgeon's Recommendation: Ultimately, the decision should be made in consultation with your orthopedic surgeon. They can assess your specific situation, including imaging studies to evaluate bone healing, and provide personalized advice based on their clinical experience.

5. Post-Removal Rehabilitation: If you decide to proceed with the removal, be prepared for a period of rehabilitation afterward. The removal of the plate may require a new phase of physical therapy to regain any lost range of motion and strength.

In conclusion, while it is possible to remove the plates after a proximal humerus fracture, it is essential to consider the potential benefits against the risks involved. If your current symptoms are manageable and your recovery is progressing well, you may choose to continue monitoring the situation. However, if the hardware is significantly impacting your quality of life, discussing removal with your surgeon could be a reasonable next step. Always ensure that you have a thorough discussion with your healthcare provider to make an informed decision tailored to your individual needs and circumstances.