Spiral Fracture - plate removal?

by Lisa
(Dublin, OH)

Had a spiral fracture in March 2015. Surgery, plate and screws and NWB for 3 months. June 30, had one screw removed (for the tendon repair) and was able to fully weight bear directly after surgery but the plate and 7 screws remain along the length of the fibula. PT started and I am completely healed... walking, running is great. Wearing heels are fine. Minor issues still are Toe box and bottom of foot still have pins and needles but ankle is great. Radiology shows a completely healed bone! YAY!

My question... since the ankle is fully repaired and the plate that is attached is doing nothing now (according to the surgeon), would you take the plate out? I am completely caught up on my deductible. Outside of some minor issues (clicking, tightness, slight irritation and the pins & needles in my foot), would you recommend getting the plate removed? What is your opinion? I was told it is an easy surgery and pretty easy recovery. Please share your thoughts - I need to make a decision before the end of November 2015.

Thanks for this wonderful site. I have posted my story and follow-up.

Lisa

RESPONSE

Hi Lisa,

In general, hardware (plates and screws) are not routinely removed unless they are causing a problem and that problem of course, is pain.

If as you say you are back to running and are able to run pain free then you had a very successful surgery and that of course was the goal. (if you read enough of the stories on this site, you will see many people do not turn out as well as you)

So the argument would be to leave well enough alone.

Along those lines becomes another issue and that is you have only had the hardware in your leg for roughly eight months. In spite of the fact that the x-rays look great and you feel great with the exception of the pins and needles, it may be too soon to consider having the hardware removed.

Most hardware is removed years after the procedure and probably the most common reason for removing hardware is that the screws start to back out and they protrude through the skin causing pain when pressed upon.

Specific to your situation is the fact that the fibula bone is a poorly vascularized bone and because of the diminished circulation to the bone, removing the hardware may result in other problems, the most evident being, re-fracturing of part of the bone.

I understand the reason for your question as it relates to your insurance. In this day and age it would make more sense to have the removal procedure since you have met your deductible for this year rather then wait for another year, but that should not be the motivating factor here.

I have never seen your leg or the x-rays, but my guess would be to leave the hardware alone as you are not having any problems. More then likely the pins and needles you are experiencing will not be resolved by removing the plate and screws.

I have put in my two cents but in reality your question should be directed towards your surgeon as he or she is the one most familiar with your situation and should be able to give you the best guidance.

Marc Mitnick DPM
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