Should You Remove a Painful Plate After a Radius Fracture?

Should the self-paid plate for a radius fracture be removed if there is pain during movement?

In early January of this year, I had a car accident that resulted in a fracture of the left radius.
I underwent surgery in the emergency department at Chang Gung Memorial Hospital, where a self-funded plate was installed.
The doctor mentioned that it usually does not need to be removed.
After the surgery, I continued rehabilitation, and by July, I was able to perform most movements with my left hand normally.
However, I experienced significant pain from the base of my thumb to the outer third of my forearm near the wrist when performing rotational movements with my wrist or spreading my thumb.

The rehabilitation physician used ultrasound to examine the area and found that the screws from the plate were protruding and pressing against the muscle.
Each treatment involved injecting dextrose to expand the space between the plate screws and the soft tissue, which alleviated the pain temporarily, but the relief only lasted a few days.
When I returned to the orthopedic department in July, the doctor believed that there was no need to remove the plate and that using my hand more would help.

I have continued treatment and rehabilitation for over two months since then, but there has been no sign of improvement.
I would like to know if I should insist on having the plate removed by the orthopedic surgeon.
My follow-up appointment with the original orthopedic doctor is scheduled for the end of December.
Should I seek a second opinion from another doctor as well? Additionally, if the plate is to be removed, how long would the recovery take before I could ride a motorcycle to work?

Wei Lun, 30~39 year old female. Ask Date: 2022/09/15

Dr. Shi Guozheng reply Orthopedics

If the bone screws indeed affect muscle activity, it is advisable to remove the screws and the plate.
After the removal of the plate, you can typically resume cycling in about two to four weeks.

Reply Date: 2022/09/15

More Info

When dealing with the decision of whether to remove a painful plate after a radius fracture, it is essential to consider several factors, including the nature of the pain, the impact of the hardware on your daily activities, and the potential risks associated with surgery.

In your case, it appears that the plate and screws are causing significant discomfort, particularly during specific movements such as wrist rotation and thumb abduction. The ultrasound findings indicating that the screws are protruding and pressing against the muscle suggest that the hardware may indeed be contributing to your pain. While many orthopedic surgeons advise against the routine removal of hardware unless it causes problems, your situation seems to warrant a closer examination.

The fact that conservative treatments, such as physical therapy and injections, have not provided lasting relief raises a red flag. If the pain persists and affects your quality of life, it may be reasonable to advocate for the removal of the plate. It is crucial to communicate your ongoing pain and functional limitations to your orthopedic surgeon clearly. If your current surgeon remains adamant that removal is unnecessary, seeking a second opinion from another orthopedic specialist could provide you with additional insights and options.

Regarding the recovery time after hardware removal, most patients can expect to return to normal activities, including riding a motorcycle, within two to four weeks post-surgery, assuming there are no complications. However, this timeline can vary based on individual healing rates and the extent of the surgery. It is also important to consider that while the removal of the plate may alleviate pain, it does not guarantee a complete resolution of symptoms, as other factors could be contributing to your discomfort.

In summary, if the hardware is indeed causing significant pain and impacting your daily life, it is reasonable to discuss the possibility of removal with your orthopedic surgeon. If you feel that your concerns are not being adequately addressed, seeking a second opinion may be beneficial. Ultimately, the decision should be made collaboratively with your healthcare provider, taking into account your specific circumstances and the potential risks and benefits of surgery. Remember, your comfort and functionality are paramount, and you deserve to have a treatment plan that aligns with your needs and lifestyle.

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