Plate Removal After Fracture Surgery: Key Considerations

I would like to inquire about the issue of removing metal plates?

Hello, Doctor.
I would like to inquire about the follow-up regarding the removal of the metal plates.
Last October, I accidentally fractured both the radius and ulna in my right arm while riding a bicycle.
I opted for two metal plates for stabilization, one for each bone.
My attending physician has been consistently scheduling follow-up appointments for me, and I had an X-ray taken last month.
The results showed that one of the bones still has a slight defect.
However, my physician assessed that the functionality of my right hand is fine, and I can lift weights of thirty to forty kilograms.
I understand that since I am no longer growing, it is unlikely for my bone density to return to 100%.
Nonetheless, I can't help but feel uncertain about any potential long-term effects, and I forgot to ask during my last visit.

Additionally, my physician mentioned that he would not schedule my next appointment unless I feel discomfort in my hand or decide to have the plates removed, which he does not recommend doing before three years.
I have discussed this with my family, and I am also considering my career plans for next year.
I plan to return for a follow-up appointment in October, which will be one year since my injury, and I want to inform my physician that I wish to have the plates removed.
I am unsure about the hospitalization process and the recommended recovery time afterward.
Thank you, Doctor.

Tsai, 20~29 year old female. Ask Date: 2015/09/04

Dr. Shi Guozheng reply Orthopedics

Fractures of the radius and ulna typically heal within a year.
After healing, an X-ray assessment can determine if the bone screws can be removed.
Delaying the removal of the screws may lead to difficulties in extraction.
Generally, the removal of screws requires no more than a week of rest, and the sutures can be removed approximately seven to ten days post-surgery.
However, it is important to avoid any vigorous activities for three to six months, especially to prevent impact on the injured forearm, as the holes from the screws will take time to fill in.

Reply Date: 2015/09/04

More Info

When considering the removal of plates after fracture surgery, there are several important factors to take into account. The decision to remove internal fixation devices, such as plates and screws, is not straightforward and should be made collaboratively with your orthopedic surgeon based on your individual circumstances.

Key Considerations for Plate Removal:
1. Healing Status: The primary factor in determining whether to remove a plate is the healing status of the bone. X-rays are typically used to assess whether the fracture has healed adequately. If there is still evidence of non-union or if the bone has not healed properly, the surgeon may recommend against removal until healing is confirmed. In your case, since one of the bones still shows a defect, it is crucial to monitor its healing progress.

2. Functional Assessment: Your surgeon has indicated that your functional capacity is good, as you can lift weights without discomfort. This is a positive sign. However, the presence of a defect in the bone may still warrant further evaluation. If the plate is not causing any functional limitations or pain, it may not be necessary to remove it immediately.

3. Time Frame for Removal: Generally, plates are not removed until the bone has healed completely, which can take anywhere from six months to a year or more, depending on the fracture's complexity and the individual’s healing capacity. Your surgeon has suggested not to wait more than three years for removal, which aligns with common practice. However, if you experience discomfort or functional limitations, it is advisable to discuss this with your surgeon sooner.

4. Risks of Removal: The removal of plates is a surgical procedure that carries its own risks, including infection, nerve damage, and complications related to anesthesia. If the plate is not causing any issues, many surgeons prefer to leave it in place to avoid these risks.

5. Post-Removal Recovery: If you decide to proceed with plate removal, be prepared for a recovery period. This can vary based on the individual and the complexity of the surgery. Typically, patients may need a few weeks to recover from the surgery, during which time physical therapy may be recommended to regain strength and range of motion.

6. Long-term Considerations: It’s essential to understand that while plates can provide stability during the healing process, they may also affect the surrounding soft tissues and joint mechanics. If you are experiencing discomfort or limitations in your range of motion, it is crucial to communicate this with your surgeon. They may recommend physical therapy or other interventions to help improve your situation.

Next Steps:
Given your situation, it would be wise to schedule an appointment with your orthopedic surgeon to discuss your concerns about the plate and the defect in your bone. Bring up any discomfort you are experiencing and ask about the potential benefits and risks of removal. It’s also a good idea to inquire about the expected recovery time post-surgery and any rehabilitation that may be necessary.

In conclusion, the decision to remove a plate after fracture surgery should be based on a thorough evaluation of the healing status, functional assessment, and potential risks. Open communication with your healthcare provider will ensure that you make the best decision for your long-term health and mobility.

Similar Q&A

Understanding Removal of Bone Plates and Pins After Humerus Fracture

Dear Doctor, In October 2008, I accidentally fractured my right humerus (near the mid-lower part) while participating in a company event. I underwent an open reduction and internal fixation with plates and screws. My recovery has been quite good, but I have a concern: my doctor ...

Dr. Li Wenlin reply Orthopedics
Hello: 1. When performing open reduction or plate removal surgery for a mid-shaft humeral fracture, there is a risk of injuring the radial nerve (approximately 10% chance), especially since the surgeon has already interacted with your tissues and has a better understanding of t...

Should You Remove Plates and Screws After Orthopedic Surgery?

In late February, I was involved in a car accident and had an interlocking plate fixed to my acetabulum. A few days later, I underwent surgery for my tibia, which was stabilized with screws. The doctor mentioned that if I don't feel any discomfort from the plates and screws,...

Dr. Chen Yongxue reply Orthopedics
Hello, 1. What are the pros and cons of removing the plate versus not removing it? The metal plate is considered a foreign body in the human body. At this stage, not removing it is unlikely to cause significant issues. However, as one ages and the body's immune system weak...

Should You Remove a Bone Plate After Healing? Key Considerations

In late April of last year, I fell while playing basketball and my hand was crushed, resulting in a comminuted fracture of the left radius and dislocation of the left wrist. The doctor performed an internal fixation surgery using a plate for the fracture (costing over sixty thous...

Dr. Hong Ximing reply Orthopedics
Hello: In the case of a comminuted fracture of the radius, if surgical reduction and plate fixation have been performed and the fracture has healed for over a year without any discomfort, there is generally no need to remove the plate. However, if there is any discomfort, you may...

Unexpected Complications After Plate Removal: Unhealed Fracture and New Surgery

Hello, doctor. I had a regrettable incident while having a plate removed in a rural area: 1. I fractured my metatarsal in early August last year and had a plate installed. A year later, during a follow-up visit, an X-ray was taken, and the doctor assessed whether the plate could ...

Dr. Wang Jiacheng reply Orthopedics
1. It is usually necessary to confirm that the fracture has healed before removing the metal plate. 2. It is possible that it has not fully healed yet.