Should plates and screws be removed after bone fractures heal?
Bone fractures are one of the most common injuries in car accidents, falls, and sports, and they may require surgical fixation using metal plates and screws to ensure proper bone alignment. But what happens after the fractures heal? Should these metal devices be removed or left inside the body? And what are the benefits and risks associated with removing or not removing them?
In this article, we will try to answer these questions based on the latest research and scientific evidence, and we will provide you with some tips and experiences related to removing plates and screws after bone fractures heal.
Benefits of removing plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing may be necessary in some cases, especially if they cause any of the following problems:
- Pain in or around the fixation site, which increases with movement or temperature changes.
- Infection in or around the fixation site, which is accompanied by redness, swelling, or fever.
- Decrease in flexibility, strength, or mobility of the joint adjacent to the fixation site.
- Slippage or breakage or extrusion of part of the plate or screw from its position, which leads to deformity or pressure on the surrounding tissues.
- Allergy or hypersensitivity to the material of the plate or screw, such as titanium or stainless steel.
- Personal desire to remove the plate or screw for aesthetic or psychological reasons.
Removing plates and screws after bone fracture healing may lead to relieving these problems, improving the patient’s quality of life, and increasing their satisfaction with the final outcome of the treatment. It may also prevent future complications, such as bone and marrow infection (osteomyelitis), bone erosion (osteolysis), bone fracture (stress fracture), bone deformity (malunion), or bone deviation (nonunion).
Risks of removing plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing is not without risks, as it requires a second surgical operation, under general or local anesthesia, and it is accompanied by a range of possible complications, such as:
- Bleeding in the wound site or under the skin.
- Infection in the wound site or in the blood.
- Damage to the nerves, blood vessels, or soft tissues adjacent to the fixation site.
- Decrease in density, strength, or stability of the fixed bones, which increases the risk of new fractures.
- Setback in healing of the fixed fractures, which leads to delay in their union or nonunion.
- Formation of scars or pigmentation in the wound site.
- Occurrence of negative reactions to anesthesia or medications used in surgery.
Removing plates and screws after bone fracture healing may increase the recovery and rehabilitation period for the patient, and it may require regular follow-up and radiological examinations to ensure the safety of the fixed fractures.
When should plates and screws be removed after bone fractures heal
There is no fixed rule that determines when plates and screws should be removed after bone fractures heal, as this depends on several factors, such as:
- Type, location, and severity of the fixed fracture.
- Type, size, shape, and material of the plate or screw used.
- Method and time of surgical fixation.
- Condition, age, health, and activity of the patient.
- Appearance of any of the problems mentioned above due to fixation.
- Request of the patient to remove fixation.
Therefore, it is up tothe patient and the doctor to decide whether to remove the plates and screws after bone fractures heal, based on the individual situation and the pros and cons of the procedure. Therefore, it is advisable to consult with a qualified and experienced orthopedic surgeon, who can evaluate the case and provide the best recommendation.
Cost of removing plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing is considered an elective surgery, meaning that it is not medically necessary, and therefore it may not be covered by some health insurance companies. Therefore, the patient may bear the full cost of the procedure, or part of it, depending on the type of insurance they have.
The cost of removing plates and screws after bone fracture healing varies from case to case, and depends on factors such as:
Country, city, and hospital where the procedure is performed.
Doctor and team who perform the procedure.
Number, type, size of the plates and screws to be removed.
Length and difficulty of the procedure.
Type and dose of anesthesia used in the procedure.
Tests and medications before and after the procedure.
Stay in the hospital before and after the procedure.
Rehabilitation after the procedure.
According to some sources , the average cost of removing plates and screws after bone fracture healing ranges from 2000 to 10000 US dollars, depending on the location and circumstances mentioned above. Therefore, the patient should consult with their doctor and insurance company before making a decision to remove fixation, and make sure they can afford this cost.
Tips after removing plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing requires some care and attention after the procedure, to ensure quick and proper healing of the wound and the fixed fractures. Here are some tips to follow after removing fixation:
Rest for a period ranging from two days to two weeks after the procedure, and avoid strenuous or painful activities.
Follow up with your doctor regularly, and perform radiological examinations to ensure the safety of the fixed fractures.
Maintain cleanliness and dryness of the wound site, and change dressings according to your doctor’s recommendations.
Take the medications prescribed by your doctor, such as antibiotics, painkillers, or anti-inflammatory drugs, according to the specified dose and duration.
Stay away from smoking or drinking alcohol or taking any prohibited substances, as these may negatively affect wound healing and fracture healing.
Consult about any signs or symptoms that are abnormal after the procedure, such as bleeding, infection, swelling, numbness, or change in color or temperature of the wound site.
Join a rehabilitation program that includes exercises to strengthen, stretch, and improve range of motion of the joint adjacent to fixation site.
Experiences of removing plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing is a personal experience that differs from person to person, depending on type and severity of injury, fixation, and removal. Here are some experiences that some patients shared on social media :
“I am a girl in 23 years old, I broke my leg in a car accident 3 years ago, and fixed it using a plate and 6 screws. I decided to remove fixation 6 months ago, because it was causing me severe pain in winter. Now I feel much better, I don’t feel any pain, and I can walk normally. I advise everyone who suffers from the same problem to remove fixation, because it improves their lives.”
“I am a man in 35 years old, I broke my arm in a work accident 4 years ago, and fixed it using a plate and 8 screws. I did not decide to remove fixation, because it did not cause me any problems, and because I was afraid of the possible risks of the second operation. I am satisfied with the result of treatment, and I don’t feel any change in my arm. I advise everyone who thinks about removing fixation to consult with their doctor and think well before making a decision.”
"I am a woman in 28 years old, I broke my ankle in a fall from stairs 5 years ago, and fixed it using a plate and 4 screws. I decided to remove fixation 3 months ago, because it was hindering my movementand preventing me from wearing the shoes that I love. Now I feel a big difference, I can walk easily and wear any shoe I want. I advise everyone who feels annoyed by fixation to remove it, because it changes your life for the better."
Doctors who remove plates and screws after bone fracture healing
Removing plates and screws after bone fracture healing is a surgical procedure that requires high skill and experience from the performing doctor. Therefore, the patient should choose a qualified and reliable doctor, who has accredited certificates and licenses, and a record of successes in this field.
According to the website , these are some of the doctors who specialize in removing plates and screws after bone fracture healing:
Dr. Mohammed Hutaif: He is a consultant of orthopedic and joint surgery, and an associate professor at King Saud University. He has more than 20 years of experience in the field of orthopedic and joint surgery, and he has performed many complex and rare surgical operations. You can visit his website for more information about his services and appointments.
Dr. Adel Al-Shammakh: He is a consultant of orthopedic and fracture surgery, and a fellow of the Royal College of Surgeons in England. He has more than 15 years of experience in the field of orthopedic and fracture surgery, and he has participated in many scientific courses and conferences. You can visit his website for more information about his services and appointments.
Dr. Ahmed Al-Sulaiman: He is a consultant of orthopedic and joint surgery, and a fellow of the Royal College of Surgeons in Ireland. He has more than 10 years of experience in the field of orthopedic and joint surgery, and he has received several awards and certificates of appreciation. You can visit his website for more information about his services and appointments.