When the plates or screws in a healed bone start to hurt
How an orthopedic surgeon weighs whether to take out metal implants
A plate, screw or rod can hold a broken bone in place while it heals. Many implants stay in for good and cause no trouble. Sometimes, though, the metal rubs under the skin, gets in the way of a movement or hurts in one specific spot. Pain can also come from the joint, a scar, a nerve, an infection or a break that never fully knit together. An orthopedic surgeon should find the cause before talking about another operation. [1]
Find where the pain comes from
Point to exactly where it hurts. Explain whether the pain comes with pressure, a certain movement, or shoes or clothing. Say if it’s there all the time. Ask if new X rays show solid bone healing and a stable implant. Promptly report fever, warmth, drainage or pain that is quickly getting worse. Your doctor needs to check those signs for infection or another complication. [1, 2]
Weigh taking it out against leaving it in
Ask how likely it is that removal would ease your specific symptom. Find out if one screw could come out alone or if the whole implant would need to go. Removing metal is still surgery. Risks can include infection, nerve damage, bleeding, trouble getting out buried metal and a bone that’s weaker for a while. If the implant wasn’t the cause, the pain may stay. [1, 2]
Think through recovery before you choose
Ask whether you’d need crutches, a boot, time off work or a short break from some activities after removal. The answer depends on the bone and the implant. If your pain is manageable, it’s reasonable to talk about watching it and trying other treatments. If you choose removal, get a clear plan for wound care and your return visit. [1]
Questions for your orthopedic surgeon
- Has the fracture fully healed, and what else could be causing the pain?
- How likely is it that removal will help my particular symptom?
- What limits and risks would come with this surgery?
Mark the sore spot before your visit
Mark the tender spot on a photo or diagram. Bring it to your orthopedic visit along with your old operation record. [1]
Sources and further reading
- 1Royal Orthopaedic Hospital removal of internal fixation
- 2Norfolk and Norwich University Hospitals removal of metalwork surgery
Consider this general education from an orthopedic surgeon’s point of view. An implant is not always the source of pain. Deciding on removal takes an exam, imaging and a talk about the risks.
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