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Should I Have My Plate and Screws Removed?

x-ray of wrist plate screwsPatients often ask, “Will the plate have to be taken out?” during our discussions about fixing bad wrist fractures or fractures in other parts of the hand and arm. Some patients ask this after a successful surgery when the bone is healed.

The purpose of a plate and screws (or any metal hardware) in fracture treatment

A plate is a flat piece of metal made of titanium or stainless steel that has holes in it. The plate fits on the surface of a fractured bone and screws are placed through the holes in the plate to hold the plate to the bone.

All the plate does is hold the fractured bone pieces together while they heal. After the bone heals, the plate and screws serve no function at all. All the strength of a healed bone comes from the bone itself. In fact, if the bone never heals, a strong plate can easily be broken in half if the patient uses the hand in a careless way!

Reasons to take out a plate and screws

Surgeons leave plates and screws in most of the time, but there are some situations that may make the surgeon or patient more willing to take out the hardware:

  • irritated tendons (can happen from a screw or the plate edge rubbing on a tendon)
  • prominent screw or hardware too close to a joint (removing the hardware may make the joint function better or be less painful)
  • a broken plate or screw (this rarely happens normally – broken plates or screws usually means something is wrong with the way the bones healed)
  • a loose screw (occasionally a screw will back out, or un-screw and irritate tendons or a nerve)
  • continued pain (sometimes pain after fracture healing can be blamed on the hardware – this is rare in my practice, but is a possibility)
  • metal allergy (this is exceedingly rare)
  • “Just get this thing out of me!” (there’s nothing wrong with this reason – most people who can’t stand to have a plate attached to their bone wouldn’t let the surgeon operate in the first place!)

The surgery

Plate removal surgery is done through the same incision as the original surgery. Here are some criteria I use for taking out hardware:

  • the fracture must be healed
  • at least three and preferably six months have passed since the original surgery

The risk of surgery is slightly higher in some ways because of the scar tissue present over the plate – it can make dissection slightly more difficult.

Recovery time is usually quicker than the original surgery, but wrist surgeons usually protect patients with a splint or limited activities for six weeks to lessen the risk of re-fracturing through the screw holes. The screw holes fill in with bone over a period of several months.

For more help

I receive many requests from people with questions about removing their plate, screws, or other hardware. I can give you more information about your situation using Google Helpouts – click on the button below to find out more information:

53 comments to Should I Have My Plate and Screws Removed?

  • Gaurav:

    From this limited information I don’t know if it’s worth going through a surgery at this point.

    The surgeon who put it in should be able to give you an idea of whether or not you would get more confidence/strength in the gym after the rod comes out.

    CNH

  • Joan:

    Sometimes infections can be activated after years of not causing problems.

    I would advise seeing either the original surgeon or an orthopaedic surgeon you trust.

    CNH

  • Liam:

    Sometimes there can be left over scar tissue over the bones that feels lumpy. Your surgeon would want to know you’re worried, so I’d see him, but surgery will likely not be necessary.

    CNH

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