Removal of Surgical Hardware

Does surgical hardware have to be removed once healing has taken place?

During many foot and ankle surgeries, hardware is used in order to stabilize the affected bones. Surgical hardware includes plates, screws, rods and other implants. In young children, such hardware is usually removed once the bones have healed to prevent problems with bone growth. In adults, the hardware is often left inside the patient unless it causes difficulty.

Why might surgical hardware in adults need to be removed?

There are several reasons a surgeon may recommend hardware removal. The most common reason is that the patient is suffering pain from the implanted materials. Other reasons may include irritation of tendons(ie peroneal tendons after ankle fracture surgery), nerve entrapment due to scarring, allergy to the implant, or incomplete healing of the bone, known as a non-union.

The Surgical Procedure of Hardware Removal

Typically, the surgeon uses the previous incision(s) to find and remove the hardware, though in some cases these incisions must be extended to perform the operation safely. In many situations, hardware removal is combined with other procedures, such as: debridement or nerve decompression if nerves have been entrapped by the development of scar tissue. In some cases, if the bone has not completely healed, further stabilization may be necessary.

Are there problems associated with hardware removal?

There may be. Since the tissues involved are frequently scarred from the previous surgery, nerves, blood vessels and other soft tissues at the site may be at greater risk than at the time of the original operation. Also, as mentioned, the surgeon may be required to make a larger incision than was necessary during the first procedure in order to remove the hardware safely.

Will there be restrictions after the removal of surgical hardware?

Depending on the particular procedure performed, the patient may have to limit the amount of weight put on the affected foot or ankle for some period of time. This will have to be clarified by the surgeon.