Is It Too Early to Remove Screws Four Months Post-Surgery?

Is it too early to remove the screws four months after surgery?

Hello, I was in a car accident in mid-November last year, resulting in a fibula fracture and a tear at the distal end of the deltoid ligament.
Although the fibula only had a small transverse fracture, the doctor still placed three internal fixation screws, and the torn deltoid ligament was sutured, followed by immobilization in a cast.
In mid-March of this year, an X-ray examination indicated that the bone had healed, and the screws had protruded, causing discomfort.
The doctor advised that they must be removed; otherwise, walking would be painful.
I would like to know if it is too early to have them removed now.
Isn’t it supposed to take a year? I’ve heard that delaying the removal allows the bone to become denser.
Is that true? Thank you.

Lingling, 20~29 year old female. Ask Date: 2005/04/01

Dr. Shi Guozheng reply Orthopedics

If the fracture has healed and does not affect stability, and there are protruding bone screws, consideration can be given to removing the screws; otherwise, it may lead to skin perforation, which would be problematic.

Reply Date: 2005/04/01

More Info

When considering the removal of screws or hardware after orthopedic surgery, several factors must be taken into account, particularly the healing status of the bone, the presence of any complications, and the potential risks associated with leaving the hardware in place. In your case, you mentioned that you had a fibula fracture and a tear of the triangular ligament, which required internal fixation with screws. After four months, your X-ray indicated that the bone has healed, and the screws are protruding, causing discomfort.

Generally, the timing for hardware removal can vary based on the type of fracture, the surgical technique used, and the individual patient's healing process. In many cases, screws can be removed once the bone has sufficiently healed, which is often assessed through follow-up imaging like X-rays. The fact that your doctor has indicated that the bone has healed is a positive sign. However, the protrusion of the screws into the soft tissue is a significant concern, as it can lead to pain, irritation, and potential infection.

Regarding your question about whether it is too early to remove the screws, it is essential to consider that the primary goal is to ensure your comfort and prevent any further complications. If the screws are indeed causing pain and have penetrated the skin, it is advisable to have them removed sooner rather than later. Leaving the screws in place when they are causing discomfort can lead to chronic pain and may hinder your rehabilitation process.

As for the notion that waiting longer for hardware removal allows the bone to become "harder," it is important to clarify that while bone continues to remodel and strengthen over time, the presence of hardware that is causing pain does not contribute positively to this process. In fact, it may impede your recovery by limiting your ability to engage in rehabilitation exercises effectively.

In summary, based on the information provided, it does not seem too early to remove the screws, especially considering the discomfort you are experiencing due to their protrusion. It is crucial to communicate openly with your orthopedic surgeon about your symptoms and concerns. They can provide personalized advice based on your specific situation, including the condition of your bone healing and the risks associated with leaving the screws in place.

In conclusion, the decision to remove screws should be guided by the healing status of the bone, the presence of any complications, and your overall comfort. If the screws are causing pain and have protruded, it is reasonable to consider their removal at this stage. Always consult with your healthcare provider to make the best decision for your recovery.

Similar Q&A

Understanding Tibial Fracture Recovery: To Remove Hardware or Not?

Hello Doctor, my son is 23 years old and previously suffered a tibial shaft fracture in a car accident. He had titanium alloy implants with four screws for fixation, and it has been 1 year and 2 months since the surgery. During his follow-up visit, the physician mentioned that it...

Dr. You Dianqi reply Orthopedics
Bone screws and plates are considered foreign objects in the body. Whether or not to surgically remove them depends on whether the patient experiences discomfort. If there is discomfort that affects daily life and work, it is recommended to follow up with the attending physician ...

Should You Remove Screws After Finger Fracture Surgery? Risks and Concerns

Hello Doctor: In May 2008, in New Hampshire, USA, I forcefully opened a stuck window, which resulted in a spiral fracture of my right index finger (specifically the segment from the knuckle to the wrist). A week after the injury, an American doctor performed surgery and implanted...

Dr. Li Wenlin reply Orthopedics
It is generally advisable for young individuals to have bone screws removed after one year, unless there are specific reasons to keep them. Removing screws from the phalanx is less likely to damage ligaments or tendons, whereas if the screws are in the carpal bones, the recovery ...

How Long Should You Wait to Remove Bone Screws After Surgery?

Hello Dr. Lee: How long should bone screws be left in before removal? I have had ankle screws for 7.8 years. Should they be removed? If not removed, will it cause any issues? Thank you.

Dr. Li Wenlin reply Orthopedics
Hello: Bone screws are generally removed one year after surgery (depending on the fracture site, some may be removed in one year, others in one and a half years). Leaving bone screws in the body without removal does not necessarily lead to complications; however, there are a few ...

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...