Should Steel Plates Be Removed After Fracture Surgery? Expert Insights

Q: Should Steel Plates Be Removed After Fracture Surgery? Expert Insights

Hello： In response to your question, I personally recommend removing the plate for your daughter for two reasons： First, she is still young, and if the cobalt-chromium alloy plate remains in the body for too long, there may be concerns about material degradation (although there a

Can the steel plate be left in place?

Hello Dr.
Li: My daughter had a car accident five years ago that resulted in fractures in both thighs, which were surgically repaired with plates and screws (one row of screws on each side).
Now she is considering surgery to remove the plates.
The original surgeon informed us that the plates could remain in place for a lifetime without needing removal.
Is this true? Since my daughter is now 21 years old and still young, she is interested in having them removed.
I would appreciate your response.
Thank you.

Mrs. Hsu, 50~59 year old female. Ask Date: 2007/12/19

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, I personally recommend removing the plate for your daughter for two reasons: First, she is still young, and if the cobalt-chromium alloy plate remains in the body for too long, there may be concerns about material degradation (although there are currently very few clinical case reports on this).
Second, prolonged placement of the plate can lead to bone loss at the contact surface; while this is less of a concern for upper limb bones, it is advisable to remove it for weight-bearing bones like the femur.
Additionally, after removal, she may need to use crutches for a period of time (one to two months) for safety.
This reasoning applies to general cases, and your daughter's situation may involve specific considerations from her attending physician, so please communicate with them further.
Such matters can be discussed! Wishing you all the best and a Merry Christmas!

Reply Date: 2007/12/19

More Info

The decision to remove steel plates after fracture surgery is a nuanced topic that depends on various factors, including the patient's age, the type of fracture, the material of the implant, and the presence of any complications or discomfort. In your case, your daughter is 21 years old and has had steel plates in place for five years following a traumatic injury.
Generally, the primary purpose of using steel plates and screws in orthopedic surgery is to stabilize the fractured bone and allow it to heal properly. Once the bone has healed, many surgeons believe that the plates can remain in place indefinitely, especially if they are not causing any discomfort or complications. However, there are several considerations to keep in mind:
1. Material of the Implant: Traditionally, steel plates were made from stainless steel, which can sometimes lead to issues such as metal fatigue or corrosion over time. Modern implants are often made from titanium, which is biocompatible and less likely to cause adverse reactions. If your daughter’s plates are made from titanium, the likelihood of needing removal decreases.

2. Potential Complications: While many patients can live with steel plates without any issues, some may experience discomfort, irritation, or allergic reactions to the metal. If your daughter is experiencing any pain or discomfort at the site of the implants, it may be worth discussing removal with her orthopedic surgeon.

3. Impact on Future Activities: If your daughter is planning to engage in high-impact activities or sports, some surgeons may recommend removal of the plates to reduce the risk of complications, such as fractures at the site of the implant. The presence of metal can also complicate future surgeries or imaging studies.

4. Long-term Considerations: As your daughter is still young, her bones are likely to continue to remodel and strengthen over time. Some surgeons advocate for the removal of implants in younger patients to allow for optimal bone health and growth.
5. Surgical Risks: It’s essential to weigh the risks of surgery against the benefits of removal. Surgical risks include infection, nerve damage, and complications related to anesthesia. If the plates are not causing any issues, some surgeons may recommend leaving them in place.

6. Consultation with a Specialist: If there is any uncertainty, it may be beneficial to seek a second opinion from another orthopedic specialist. They can provide insights based on the latest research and their clinical experience.

In conclusion, while it is true that many patients can live with steel plates for life without any issues, the decision to remove them should be based on a thorough evaluation of your daughter's specific circumstances. If she is experiencing discomfort or has concerns about future activities, discussing these with her orthopedic surgeon will help determine the best course of action. Ultimately, the decision should prioritize her comfort, health, and lifestyle aspirations.

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