Should You Remove Plates and Screws After a Humerus Fracture?

After a mid-shaft humeral fracture, is it necessary to remove the screws and plates in the future?

Hello Dr.
Zhan,
A month ago, I had an accident that resulted in a mid-shaft humeral fracture.
I had an 11-hole plate and 7 screws implanted.
Currently, my shoulder range of motion is normal, and my elbow can flex to about 110 degrees; I am still working hard on rehabilitation.
After consulting with the surgeon, I was informed that the hospital does not recommend removing the screws and plate, and if removal is necessary, it should be done after one year.

After researching many articles, I learned that there is a risk of injuring the radial nerve during the removal of the plate and screws for mid-shaft humeral fractures.
Although I have not fully recovered yet, based on others' experiences, I am aware of the following concerns if the hardware remains in my body:
1.
Since I am only 28 years old, if I do not have the hardware removed, it will remain in my body for approximately 40-50 years, which raises the possibility of corrosion.
Other articles suggest that it is best to remove it at a young age.
Is 28 years old considered an appropriate age for hardware removal?
2.
It may affect my athletic performance and the intensity of my strength training.

3.
There is a sensation of having a foreign body present.

4.
If the screws and plate are to be removed, it should ideally be done one year later; otherwise, the longer they remain, the more difficult the removal may become.

Although I have not fully recovered yet, I am unsure about the presence of the above issues.
Of course, I will consult with my attending physician again in a year.
Dr.
Zhan, how should I best assess this situation? Thank you, doctor.

Ray, 20~29 year old female. Ask Date: 2020/10/31

Dr. Zhan Xian reply Orthopedics

Hello Ray, as you mentioned, we need to consider the factors regarding whether to extract it.
We can discuss this with the attending physician once the fracture has healed.

Reply Date: 2020/10/31

More Info

When it comes to the decision of whether to remove plates and screws after a humerus fracture, there are several factors to consider, especially given your age and current recovery status. Here’s a comprehensive overview based on your situation and the general medical knowledge surrounding this topic.

1. Age and Longevity of Hardware: At 28 years old, you are relatively young, and the thought of having metal hardware in your body for potentially 40-50 years is understandably concerning. While it is true that plates and screws can remain in the body indefinitely without causing issues for many patients, there is also a risk of complications over time. These can include irritation of surrounding tissues, potential infection, or even hardware failure. However, many individuals live with these implants without significant problems.

2. Risks of Removal: Your surgeon's caution regarding the removal of the hardware is valid. The risk of nerve injury, particularly to the radial nerve, is a concern during the removal process. Studies indicate that the risk of nerve injury during hardware removal can be as high as 10%. This risk is particularly pertinent if the hardware is deeply embedded or if there is significant scar tissue formation around the area.
3. Impact on Physical Activity: You mentioned concerns about how the presence of the hardware might affect your athletic performance and strength training. While some individuals report a sensation of discomfort or a foreign body feeling, many others do not experience any significant limitations in their physical activities. If you are currently able to perform exercises and your range of motion is improving, this is a positive sign. However, if you begin to experience pain or limitations in your activities, it may warrant further discussion with your orthopedic surgeon.

4. Timing of Removal: The general recommendation is to wait at least one year post-surgery before considering hardware removal. This allows sufficient time for the bone to heal properly and reduces the risk of complications. If you are still in the recovery phase, it may be premature to make a decision about removal.
5. Consultation with Your Surgeon: It is crucial to maintain open communication with your orthopedic surgeon. They have the best understanding of your specific case, including the nature of your fracture, the healing process, and any complications that may arise. If you have concerns about the hardware, express them during your follow-up appointments. Your surgeon can provide personalized advice based on your healing progress and any symptoms you may be experiencing.

6. Future Considerations: If you decide to keep the hardware, it is essential to monitor your symptoms. If you experience persistent pain, discomfort, or any functional limitations, it may be worth revisiting the discussion about removal. Additionally, if you notice any signs of infection or unusual symptoms, seek medical attention promptly.

In conclusion, the decision to remove plates and screws after a humerus fracture is multifaceted and should be made collaboratively with your healthcare provider. Consider your current recovery, potential risks, and personal preferences. It’s also beneficial to weigh the pros and cons of keeping the hardware versus undergoing another surgical procedure. Ultimately, your orthopedic surgeon will guide you best based on your unique circumstances and recovery trajectory.

Similar Q&A

Should You Remove Plates and Screws After Arm Fracture Surgery?

Hello, I sustained a closed fracture of the right humerus while throwing a baseball on February 27 of this year, and I underwent surgery in early March. I have mostly recovered now and would like to know if there is a necessity to remove the plates and screws in the future. The p...

Dr. Wang Shouji reply Orthopedics
Hello: When removing the plate after a humeral fracture, it is important to consider the risk of injury to the radial nerve. Titanium alloy has less stress shielding effect, and based on my assessment of the risks, I do not recommend removal. Thank you!

Is It Safe to Remove Bone Plates After Four Years of Humerus Fracture?

Is it appropriate to remove the steel plate and screws from a right humeral fracture that occurred four years ago?

Dr. Shi Guozheng reply Orthopedics
If there is no discomfort in the area, it is possible not to remove the hardware. If removal is necessary, it is important to ensure that the fracture has healed. Additionally, when removing the bone screws at the surgical site, care must be taken regarding the course of the nerv...

Should You Remove Steel Pins After Humerus Fracture Healing?

After the car accident, I fractured my right humerus. After being stabilized with six screws and one plate for over a year, I want to have the screws removed. My attending physician said it may not be necessary to remove them because there are many nearby nerves, and there is a r...

Dr. Wang Shouji reply Orthopedics
Hello: Considering the risks associated with surgery, I also recommend that it may not be necessary to remove it, as scarring in the surrounding soft tissue after surgery can increase the likelihood of nerve injury. If nerve damage occurs, the potential for long-term complication...

Understanding the Risks of Leaving Bone Screws in After Surgery

On March 13 of this year, I sustained an open fracture of the humerus. The doctor advised against removing the plates and screws due to concerns about nerve damage. If I still wish to have them removed, it can be done, but there are risks involved. Could you please explain what p...

Dr. Shi Guozheng reply Orthopedics
Not removing it will not have a significant impact. In the case of a humeral fracture with plate fixation, there is a risk of injuring the radial nerve, which could result in an inability to extend the wrist.