Removal of osteosynthesis material (plates, screws, rods)

Removal of osteosynthesis hardware is a planned orthopedic surgical procedure of low to moderate complexity in which the surgeon removes metal implants (plates, screws, rods, pins) previously used to stabilize a fracture. The intervention is usually performed after complete bone healing or when the implant causes discomfort, irritation, inflammation, or has become loose.

Role of the Procedure

The main goal of the intervention is to restore local comfort and mobility of the affected limb, prevent late complications (chronic inflammation, irritation, tissue reactions), and prepare the area for possible future orthopedic procedures.

Indications

• Complete bone consolidation following osteosynthesis.
• Pain, discomfort, or local irritation at the implant site.
• Infection or inflammation around the osteosynthetic material.
• Loosening, deformation, or partial fracture of the hardware.
• Need for a new orthopedic procedure in the same region.

Preoperative Preparation

• Clinical examination and imaging investigations (X-ray, CT, MRI) to assess the position and condition of the implant.
• Mandatory communication with the physician regarding all medications taken, including anticoagulants, antiplatelet agents, anti-inflammatory drugs, and cardiac treatments.
• Observance of fasting guidelines: no food for 6–8 hours before surgery and no liquids for 2–4 hours prior (according to anesthesiologist recommendations).
• A hygienic shower on the day of surgery is recommended; wear light, comfortable clothing that does not restrict movement.

Procedure

The surgery is performed under regional or general anesthesia. The surgeon makes a small incision over the implant, removes the metal material, and checks bone stability. The incision is then sutured, and a sterile dressing is applied locally.

Duration and Recovery

The operation generally lasts between 30 and 60 minutes, depending on the number and type of implants. Recovery is usually fast and associated with minimal discomfort; the patient can resume normal activities after a few days, following the physician’s recommendations.

Hardware removal is a safe, routine orthopedic procedure that helps improve patients’ quality of life after fracture healing.

Sources:

https://www.orthobullets.com/trauma/422953/symptomatic-hardware-and-implant-removal
https://www.bjoms.com/article/S0266-4356(08)00160-5/abstract
https://pmc.ncbi.nlm.nih.gov/articles/PMC4170248/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7532570/
https://pubmed.ncbi.nlm.nih.gov/33008477/
https://journals.lww.com/jaaos/abstract/2006/02000/hardware_removal__indications_and_expectations.6.asp