Just to add to what everyone else has said, I have had a plate and two screws in my wrist since 1994. No problems at all at any point so far.

tony

I shattered my ankle at a Cyclocross Race in 11/2012 requiring surgery and insertion of a plate and 8 screws. Even after PT, extra time off from my activities, it never felt right. I was not able to run, ride my bike as well as I wanted or, for that matter, walk without a limp. I had a 5 degree deficit in ROM even a year later with significant swelling and irritation. I made the decision pretty early on that the hardware was coming out. In October 2013, at my last checkup with my ortho, he agreed to the removal and on 11/2/13 I had the alien hardware removed. That afternoon, 4 hours after coming home from surgery, the difference was miraculous. My whole body felt better, my ankle, even with an 8" surgical incision, felt fantastic. I was limited weight-bearing that afternoon, walking in my boot the next day and pain free...yes pain free!!!! At the two-week check-in, I had full ROM returned and even my doctor was amazed the the difference. I am 10 weeks out, actively riding my bike and doing something I have haven't done in over a year...running. Yes, it gets a little swelly after a good workout...but I can get out of bed in the morning and actually walk normally versus looking like Frankenstein's monster for 15 minutes

Now, recovery. Yes, you have to take it easy (not easy for us), but when you know that 6 weeks off will make you stronger - you get OK with it pretty quick. I never stopped with modified core training (no planks or anything requiring twisting or torque on the ankle) and was on the trainer by week three for easy spinning and cleared for all activity by week six. The x-rays still showed the holes in my bone at the 6 week mark, but they had already begun to calcify and should be filled in my week 16-18, according to my doc. So, I am taking it easy. No MTB'ing (easy in the winter in the 'Nati), no trail running (again, pretty easy) and limited running on pavement.

End of the day...I do believe there are people out there like me whose body just does not like the hardware. While my doctor was willing to remove my hardware at the one year mark, he was quick to suggest it might not make a difference with the issues I was having. He was honestly taken aback at the significant improvement he saw. Please, if you are having issues (likely an inflammatory response to the metal content of the hardware), please do not hesitate and have a serious discussion with your ortho about hardware removal.

In Feb. 2007 I broke my right Tib and had a rod and two screws put in. In August 2008 I had a herniated disk in my neck (C4-5) and had the disk removed, synthetic bone installed and a plate and two screws. In Nov. 2008 I broke my left tib/fib and had another rod inserted and 4 screws. Like others said, I can feel the head of the screws in my knees but they don't bother me. It wasn't until 2011 that I started Tri's and running and they still don't bother me.

2 plates and 10 screws put in to repair a compound radius/ulna fracture when I was 11. Had them taken back out 9 months later. I was still growing and recovered pretty quickly after they were removed. You never really get used to feeling the screws under your skin. And I'm not sure if it's still the case, but my orthopedist scraped off the calcium deposits from the plates and packed them into the holes where the screws were to help aid in repair. Said otherwise, they would need to harvest from cadavers. It was all really interesting for a then 12-yr old kid to hear. The only issue I have is I think he cut some muscle that didn't quite heal right. I now have a small bulge and indentation on my left arm whereas the right transitions from forearm to wrist smoothly. Doesn't affect function that I'm aware of.

Nothing new to add, but just another anecdote. The biggest issues are that you 1) have to go through surgery again, with all the risks just inherently associated with that. After that, 2) the bones are really fragile while healing and having the holes from the pins fill in, and if they break, well, you may need yet another surgery.

On the plus side, you get rid of the pins and plates.

Just anecdotally, the ankle seems to be one place where people very, very often get the stuff removed. There's just so much ROM in that joint, it never seems to work "right" with hardware in it....

---

"Non est ad astra mollis e terris via." - Seneca | rappstar.com | FB - Rappstar Racing | IG - @jordanrapp

I shattered my collarbone in 6 places while racing and had a plate w/ 9 screws put in which i thought would be there for life. For 1.5 years, it was sore all the time and if I put a barbell on my shoulders, it would bump up against it which hurt like hell. You could actually feel the screws through the skin and visibly see the plate so I took it out. As others say:

1. Required another surgery but I was in/out within 2 hrs at an outpatient center (and i got to keep my plate!).
2. The bone was full of holes so no riding for a couple of weeks. They fill in eventually but is really susceptible to break right afterward

The reason I bring this up is that 4 weeks of inconvenience shouldn't sway you on long term solution. If it is bothersome and/or hurts, remove it. I'm really glad I did.

September 2nd I was hit by a car while on a training ride. It was a compound fracture or break of the fibula and tibia. I'm laying on the street looking at this bone sticking out of my leg while I call my wife.TMI I know but anyway, 4 months later, a titanium rod from my knee to me ankle, and pins to boot, I'm getting back to normal. The pins bother me when I swim though. I'm in hopes that I will get used to it. It's just a weird feeling. I'm also a little concerned about my running gate changing some but I haven't got back to running yet. I'm back on the bike though and my heel seems to stay (kick) out more than it used to while pedaling. Is this maybe just compensating for the loss of conditioning during the last four months of healing?

I have had 26 screws and 6 plates residing in my pelvis since 1997 (47 at the time) as a result of a bike crash. Since then I have completed 4 IM's, 1 marathon and countless other tri's and running events with no real issues. I elected not to have them removed due to the size of incision required (almost 1/2 the circumference of my waist) and the corresponding recovery time. And, yes,I have set off one airport metal detector.

---

Dean Wilson
http://www.anaerobiczone.com
Bicycle Protection Indoors & Out

Now I feel really good to go for it. I had ski accident February 2013 broke Tibia and Fibula (ORIF). L plate and 11 screws. Started walking with limp 3 months later. Running very slow 4 months later. 5k in June and November half marathon but as I mentioned very slow. My OS amazed with my recovery but the whole time I have pain, swelling, stiffness and otherness specially after running. OS recommended HW removal. It is scheduled March 26th . Very excited to see the result. Thanks very much for posting your experice.

Not the same...but my wife had rods put in her back when she was 16. (scoliosis)

6-8 years later, we found out that the whole area around the rods was infected, so they cut her open and took out the hardware.

I've got a stainless steel plate and 10 screws in my collarbone thanks to a nasty crash at IM 70.3 NOLA that gave me a double compound fracture. My breaks required surgery but, as you may have heard, the orthopedists are using surgical intervention a lot more commonly now to speed up healing, especially in active people. I was told that the standard is to keep the plate and screws in about a year before considering removal. Criteria for removal include infection and discomfort. I don't have discomfort so I am opting to just let it be. I don't want another round of general anesthesia and the pain and associated "off time" that surgery requires. The surgeons say the removal is a lot "easier" on patients than the fixing, but still. I keep waiting for it to set off metal detectors but it never has. I've also been able to have an MRI of my neck with it - the orthopedists and radiologists said that once it is firmly anchored to the bone it was not a contra-indication for MRIs. That is my experience - hope that helps.

---

It is the mind itself which builds the body.
-Joseph Pilates

The rule of thumb is that if the hardware is not causing pain or discomfort then leave it in, if it is causing pain and discomfort *then*, and only then, consider having it removed.

The screws can back out, but that usually shows within the initial 2-3 months.
It takes a full year for soft tissue (tendons & ligaments) to completely heal.
Bone will be basically healed after 3 months, assuming good blood flow (bones without good blood flow, i.e. scaphoid, take 4 months). However, the bone will continue to re-matrix itself for a year in order to find the best structure for the stress in that area.

When screws are removed the marrow fills in the holes within a couple of days but it takes a good 6 weeks to be strong again: and the same rules apply as above. Also, opening the body always introduces the potential for infection. Risk for post-op infection lasts a full year.

You don't want to re-fracture a bone in the same place that hardware already exists. The damage to the body can be disastrous. However, full activity is possible with proper strength training and body balancing. The normal PT usually isn't enough to relearn how to use the muscles properly, and to train the body in how to be balanced. Ongoing, longterm strength training is recommended. If you do experience discomfort in the area of the hardware, try to find a *real* osteopath (one who treats as the medicine was designed): they can work wonders in removing the trauma from the body.

Note: After a pilon fracture of my right ankle, surgeons initially told me that repetitive impact sports were out for me. Fortunately, getting the surgeon onboard to doing the best possible job, the support of good friends, gathering a 100% positive team of sports minded practitioners, as well as tons of stubborn belief and motivation on my part, the doubters have been proven wrong.

---

/Howie Nordström

I broke both bones in right arm in 2007 & have plates & screws in both. I had 7 months of PT & recovered all movement & strength in arm. They have caused no pain & are not inconvenient in any way. I have had 3 bouts of cellulitis in very near proximity to one of the plates/screws & don't know if there is any relation to the hardware & infection or not. I have had to take very strong antibiotics to get rid of the infection when it occurs. Has anyone had this problem & could the two be related???

Same here, but there's no discomfort and I figure the plate provides protection should I fall on the same shoulder again. Besides, my SO won't let me get a tattoo, so its the only cool thing I've had added to my body. You can see a few of the screw heads in the right light.

---

Damn, that's a cold ass honkey.

Cellulitis can definitely be caused by surgery.

---

/Howie Nordström

I work in the medical device industry, I'm no doctor but I do research into implant design and effectiveness. my main area of research is into knee implants but this applies to all implants in general:

In the long run, having NO hardware is always better. if you have the option to let your bones heal naturally rather than insert hardware without too much inconvenience my friend chose that route despite snapping his tibia- crutches for 4 months but he has healed way better than he would have with pins and hardware inside).

Bone is a living material and they remodel themselves based on stress/strain they experience- think about how an athelets bones are stronger than a paraplegics bones, or how inactive people are prone to osteoporosis later in life. having hardware in your bones changes the stress experienced by the bones- and hence affects how strong they will eventually become. if you're interested to know more, google wolffs law or the law of bone remodelling.

so, it is true that if it ain't broke, don't fix it. BUT this may lead to complications further down the road when you're old and grey and want the most out of your bones. and there is always the chance of corrosion of those metal hardware in the long run.

Pros: you return your body to something more in line with it's natural state, which is always good. less likelihood of problems down the road, especially if you think you may not be so healthy in old age.

cons: another surgery, temporary weakness as those 'holes' heal.

iam a newbie here in a similar situation, on 01/08/13 i was in a motorcycle accident where i snapped my tibia and fibula and dislocated and fractured my talius, also broke 2 toes and 2 metatarsuls along with tearing the ligaments (acl) in my knees, have been going to physio to try and get muscle built up as i lost 2.5 stone in hospital.
i can now put a bit more weight on it but still cant walk properly or run or even kick a football, iam very active and this is driving me nuts, the last xray showed that the talius and tibia are healing ok but the fibula hasnt healed at all.
its been 9 months now iam 28. my last consultant specialized in lower leg injuries and he said that if it hadnt healed by now it would need bone grafting, yet my new consultant thinks its the open wound that is causing infected flesh and therfore stopping fibula from healing. he wants to remove the 2 large screws from the tibia and that will solve everything.
still get pain with movement probably from the fibula.
is this a good idea to remove the tibia screws when the fibula hasnt even started healing,

Hi,tacetman,

I had a skiaccident Feb 2013. Broken Tibia and Fibula, ORIF. 12 Screws and 1 long L plate.My OS scared me as much as yours. After 3 months I started jugging thenrunning. I did a Half Marathon last November although had always weird feelingand discomfort all around my injured leg and knee until I had my hard ware removed March 2014. I only had my crutchesfor 1 week and started walking the evening of the day of surgery with 50% weigh.I started running after a month. I had a really short and convenient recovery nothing compare with the 1st one.I am happy I decided to remove HW because my leg is much more flexible and I run and do other activities faster and easier. Having said that, please note this is only myexperience as a patient who knows very few about a surgery or medical Procedures. However ifyou want to remove the HW, you better decide sooner than later to have a smooth and easy surgery. I hope ithelps.

Hi. Did you have the HW removed? How did it go? What restrictions were there post removal?
Thanks. Tom