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

Removal of fracture fixation plates and screws?

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

h, 20~29 year old female. Ask Date: 2015/08/11

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 nerves.
For example, if the fracture is near the elbow, special attention should be paid to the radial nerve.

Reply Date: 2015/08/11

More Info

When considering the removal of bone plates or screws after a humerus fracture that occurred four years ago, several factors must be taken into account. Generally, if the fracture has healed properly and the patient is not experiencing any discomfort or complications related to the hardware, it may not be necessary to remove the implants. However, the decision should be made on a case-by-case basis, ideally in consultation with an orthopedic surgeon.

Factors to Consider:
1. Healing Status: The primary consideration is whether the bone has healed adequately. This can be assessed through imaging studies, such as X-rays, which can show the integrity of the bone and the position of the hardware. If the bone is fully healed and there are no signs of complications, the need for removal may be diminished.

2. Symptoms: If the patient is experiencing pain, discomfort, or any other symptoms that could be attributed to the hardware, this may warrant removal. Common issues include irritation of surrounding tissues, infection, or mechanical problems such as loosening of the screws or plates.

3. Location of the Hardware: The location of the implants is also crucial. For example, if the hardware is near nerves or blood vessels, there may be a higher risk associated with removal. In the case of a humerus fracture, if the hardware is located near the elbow, special attention must be paid to the radial nerve, which runs in close proximity.

4. Patient's Activity Level: The patient's lifestyle and activity level should also be considered. If the individual is active and engages in sports or physical labor, they may be more prone to complications from retained hardware, and removal might be advisable.

5. Potential Risks of Removal: While removing the hardware can alleviate symptoms, it is not without risks. Surgical removal can lead to complications such as infection, nerve damage, or delayed healing. Therefore, the benefits of removal must outweigh these potential risks.

Recommendations:
- Consultation with an Orthopedic Surgeon: It is essential to have a thorough evaluation by an orthopedic specialist. They can assess the healing status of the bone, review any symptoms, and determine whether the hardware is causing issues.

- Imaging Studies: Follow-up imaging, such as X-rays or CT scans, can provide valuable information about the healing process and the condition of the hardware.

- Monitoring Symptoms: If there are no symptoms or complications, the patient may choose to leave the hardware in place. Many individuals live with retained hardware without any issues.

- Consideration of Future Activities: If the patient plans to return to high-impact activities, discussing the potential risks of retained hardware with the surgeon is crucial.

In summary, while it is often safe to leave bone plates or screws in place after four years if there are no complications, the decision to remove them should be individualized based on the patient's specific circumstances, including the healing status, symptoms, and potential risks associated with removal. Always consult with a qualified orthopedic surgeon to make an informed decision tailored to your health needs.

Similar Q&A

Should You Remove Plates and Screws After a Humerus Fracture?

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. ...

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.

Understanding Humerus Fractures: Recovery, Rehabilitation, and Plate Removal

Hello, Doctor. In early June of this year, I suffered a left humeral fracture due to a fall. Currently, I can raise my arm to a certain height and angle, but I am unable to lift it beyond that. I visited an orthopedic clinic, and they mentioned that I have joint stiffness and adh...

Dr. Wang Shouji reply Orthopedics
Hello, if it is a mid-shaft humeral fracture, it should have a temporary impact on the shoulder joint, and the plate is unlikely to affect shoulder joint mobility. However, if it is a proximal humeral fracture, there may be some impact on shoulder joint function, and removal of t...

Should You Remove Plates After Proximal Humerus Fracture Surgery?

Hello, Doctor: I was in a car accident in September of this year and sustained a proximal humeral fracture on the left side (with two cracks at the shoulder joint). I underwent fracture reduction and internal fixation with a steel plate on the lateral side of the proximal humerus...

Dr. Chen Yongxue reply Orthopedics
Hello, generally speaking, the removal of the steel plate and the insertion of the fracture fixation are along the same pathway. If the insertion was smooth, during the removal, one just needs to be cautious of nerve traction due to scarring.

Concerns About Long-Term Effects of Bone Plates and Screws After Fracture

On March 13 of this year, I was involved in a car accident that resulted in an open fracture of my left humerus. Last week, I consulted with my doctor regarding the need to remove the metal screws and plates after a year and a half. The doctor advised against removal, expressing ...

Dr. Chen Xingyuan reply Orthopedics
Dear Readers, In principle, temporary fixation devices such as steel plates and screws implanted in the body should be removed as soon as possible after the fracture has healed. While it is possible to leave these fixation devices in place, there are several considerations: 1. ...