Do I Really Need to Remove My Titanium Bone Fixation Device?

Q: Do I Really Need to Remove My Titanium Bone Fixation Device?

Hello： In response to your question, some implants are indeed not considered for removal. <br>Each individual's situation is different, and there is no one-size-fits-all principle. <br>Your attending physician will take various conditions and concerns into account to make the bes

Do you really not need to take it?

Hello, Dr.
Li! I have a question for you.
Four years ago, I had an open comminuted fracture of my thigh from a car accident.
Last week, during a follow-up appointment, I told my attending physician that I wanted to remove the fixation device that is in my thigh, but he said that the device is made of titanium alloy and does not need to be removed for life.
Is this correct? I feel that my attending physician is concerned about bacterial infection because I had a bacterial infection during my hospitalization, and I was on antibiotics for a long time, even receiving three different generations of them.
Dr.
Li, if I undergo surgery and unfortunately develop a bacterial infection again, will there still be antibiotics available for treatment?

A-Ding, 20~29 year old female. Ask Date: 2005/09/05

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, some implants are indeed not considered for removal.
Each individual's situation is different, and there is no one-size-fits-all principle.
Your attending physician will take various conditions and concerns into account to make the best judgment for you, and I trust that their decision will be in your best interest.
Additionally, titanium alloys are indeed more biocompatible compared to cobalt-chromium-molybdenum alloys, which can cause toxicity, and they can potentially remain in the body for a lifetime without the need for removal.

However, the general practice is to remove non-autologous materials whenever possible, provided it does not lead to any complications.
This approach is generally accepted by both patients and physicians.
On the other hand, in certain special circumstances—such as when a fracture has not healed properly, or there is a risk of hidden infection, or if it requires cutting through bone and damaging the joint to access the implant—the cost of removing the implant may outweigh the benefits.
In such cases, it is advisable not to attempt to remove the implant.
Wishing you all the best!

Reply Date: 2005/09/05

More Info

When it comes to the question of whether you need to remove your titanium bone fixation device after a severe injury, such as a compound fracture, the answer is generally no, especially if your surgeon has advised against it. Titanium is widely recognized for its biocompatibility, meaning that it is less likely to cause adverse reactions when implanted in the body. This is one of the reasons why titanium is commonly used in orthopedic surgeries, including the fixation of fractures.

Your surgeon's recommendation that the titanium fixation device does not need to be removed is based on several factors. First, titanium implants are designed to integrate with the bone over time, a process known as osseointegration. This means that the bone grows around the implant, effectively anchoring it in place. In many cases, once the bone has healed sufficiently, the presence of the implant does not interfere with normal function and can remain in the body indefinitely without causing problems.

However, there are exceptions to this general rule. If there are complications such as infection, non-union of the fracture, or if the implant becomes loose or causes pain, then removal may be necessary. In your case, since you mentioned a history of bacterial infection during your hospitalization, it is understandable to have concerns. If an infection were to occur post-operatively, antibiotics are typically available to treat it. The choice of antibiotics would depend on the type of bacteria involved and their sensitivity to specific medications. In many cases, a combination of antibiotics may be used to effectively combat the infection.

It's also important to note that while titanium is less likely to cause allergic reactions or toxicity compared to other metals, there is still a small risk of complications. For instance, if the implant were to migrate or cause irritation to surrounding tissues, your healthcare provider might consider removal. However, these situations are relatively rare.

In summary, unless there are specific complications or concerns regarding the fixation device, it is generally safe to leave titanium implants in place. Your surgeon's decision is likely based on a thorough assessment of your individual circumstances, including the nature of your injury, the healing process, and any potential risks associated with removal. If you have ongoing concerns or experience new symptoms, it is essential to communicate these with your healthcare provider. They can provide further evaluation and guidance tailored to your situation.

Lastly, regarding your concern about the potential for infection if surgery is required in the future, it is crucial to discuss this with your surgeon. They can provide you with a plan for antibiotic prophylaxis if necessary, ensuring that you are adequately protected against infections during any future procedures. Always feel free to ask questions and express your concerns to your healthcare team; they are there to help you navigate your recovery and ensure the best possible outcomes.

Similar Q&A

Do I Need to Remove Titanium Pins After Scaphoid Fracture Surgery?

Due to a car accident, I sustained a fracture of the scaphoid bone in my right hand. The physician determined that it requires fixation with a metal screw, initially mentioned to be titanium alloy, but it is uncertain whether it is a steel screw or titanium alloy. Since I am rela...

Dr. Shi Guozheng reply Orthopedics
There is no need for removal unless there are uncomfortable symptoms. Typically, the intramedullary nail is embedded within the bone, so removal is not necessary.

Do You Need to Remove Plates and Screws After High Tibial Osteotomy?

Hello, after undergoing high tibial osteotomy approximately two years ago, is it necessary to have another surgery to remove the plates and screws? What are the potential consequences if they are not removed? Thank you.

Dr. Wang Shouji reply Orthopedics
Hello, if it has healed, you may consider removal, as current internal fixation devices are made of titanium alloy. If you choose not to remove it, there is no significant issue. Changhua Hospital cares about your health. Sincerely, Dr. Wang Shou-ji.

Should You Remove Titanium Screws After Fifth Metatarsal Fracture?

The recommendation for removal is based on the fact that the patient would have to live with the bone screws and plates for the next 50-60 years, which could introduce additional uncertainties. Since the lower extremities bear significant weight, there is a possibility of develop...

Dr. Shi Guozheng reply Orthopedics
1. It is possible. 2. There is no increased risk of fractures because continued walking makes it less likely to develop osteoporosis. There may be temporary cavities, but over time, the bone will regenerate and fill in. 3. Removing it requires another surgery, which carries its o...

Should You Remove Titanium Intramedullary Nail After Humerus Fracture?

Currently, I have a spiral fracture of the left humerus that has been treated with a titanium intramedullary nail. However, I am experiencing discomfort and a foreign body sensation, and I plan to have it removed after one year (which will be in August this year). My doctor advis...

Dr. Chen Yongxue reply Orthopedics
In fact, bone screws are not part of the body's original tissue, and they should ideally be removed after the staged tasks are completed. However, there is a risk of injuring the radial nerve when removing the plate at the site of a humeral fracture. Thank you.