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Hardware: Should the hardware be taken out?

The decision to have elective surgery or any other form of treatment is, in general terms, always the same. Is the benefit to be expected from the surgery so great that the risks are worth taking? If you look at that question there are three issues

1. Benefits to be expected. They depend on each individual case but where screw heads are sore, taking them out is expected to relieve the pain. You must be satisfied the OS has explained the benefits of the operation to you.
2. The risks. How severe are they? How probable are they? Once again, you are entitled to be thoroughly satisfied that you have understood all the risks, when you have an operation. Many people are prepared to take this on trust but if you want to know, ask. It is a good idea also to ask about the risks of not having the operation.
3. Balance between risk and benefit. Only you can answer that. If you believe that the pain is severe, will go away after the surgery and that the risks are minimal you will likely decide one way. If the benefits are likely to be minimal and the risks of non-operative treament are acceptable then you will likely choose the other way.

Myles Clough MD OS Jan 3 2002

From: cathie

Two comments:
1. The OS told me it was routine to remove a tibia plate after about 18 months to two years, but the fibula plate could stay forever if it did not bother me. As I understood it, the tibia plate is removed because the plate is large enough that the bone underneath will be affected adversely if it stays on too long.
2. Some research I have read about hardware removal indicates that removal does not always reduce pain as much as patients expect. Sorry, don't have the URL.

From: Caathy

My OS said that the plate and screws must stay in. I had a tibia plateau fracture on 10/29/02 and still have a lot of pain. The more I do and the more I walk, the more it hurts. One screw on the x-ray goes right through the tibia. The OS didn't seem concerned so I never asked but I wonder if that's why I have some of this pain.

From: Joe

Caathy, I also had a tibia plateau fracture during sept. 2002, surgury on the 1st of oct. I have two screws all the way through the tibia (well, almost) and a graft. I have that same deal of it hurting more as the day goes on, and also the screw heads seem to pierce my flesh every time i bend my leg.

From: saeed

my left leg was fractured in 1974 it involved tibia.bone plating was done becouse of nonunion eventually it healed but the plate is still there after 30 years i am a regular jogger sometimes it become very painful any advise?

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