Hardware removal after tibial plateau fracture (tpf)

Posted by rileydog @rileydog, Oct 6, 2017

I am looking for others that have had experience with hardware removal after a tibial plateau fracture. I had my surgery in March of 2016 and am still experiencing discomfort from the hardware (plate and six screws) and am considering having mine removed. Would love to hear of your experience.

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@skronky100 I had a bad lateral tibial plateau fracture in June 2020 (my surgeon said I had basically obliterated that part of my tibial plateau, way to go me!). No other break though. I have a rather long plate, about 15cm and 10 screws. I have similar sensations to those you describe when weight bearing, which I attribute to the screws and the plate itself. My tibia feels like it's in a vice and very rigid. I also have some discomfort when walking, through the tibia where the upper screws are located. Luckily for me, while not pleasant, it is tolerable.
That said, I am actually getting my hardware removed in a few weeks' time. I'll also be having an arthroscopy to clean out residual debris from my knee.
Like some other posters here I was unsure about whether to have the hardware removed. I'm not thrilled with having more surgery and am also worried that something could go wrong. Having done some research and asked around, it does seem that most people feel a lot better after hardware removal. The chance that my knee and leg might feel more natural has been enough to tempt me. I have the same surgeon who did my original op. He'd told me to wait 24 months before undergoing any hardware removal.
Hope this info is helpful to you.

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Your post was very helpful. I also had a traumatic leg injury and I had a comminuted bicondylar tibial plateau fracture; fractured fibula and medial meniscus tear in April 2021, I had external fixator placed followed by ORIF with plate and screws. I have been exercising a lot, but I can tolerate bike riding more than walking. My shin feels very tight and every so often unexpectedly, I get a sharp pain right into the soft tissue of my knee that stops me in my tracks, sometimes takes me a little off balance. I want to get the hardware replaced but those close to me think I’m crazy to undergo another surgery. I don’t feel that way because I’m the one who is suffering. What should I do?

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@rodney79

Hi, I know this is an old post maybe you will respond. I had a 5cm crushed tibia plateau and tibia fracture requiring 2 plates and 6 screws. I'm 7 month post op. My knee joint feel great with good movement. I have bad pain down my tibia to my ankle, the fracture was only 6 inches down from the top of my knee. I feel that the plate is keeping my tibia from flexing when I walk or stand naturally. Idk for sure. What I do know is I have bad pain and I feel the hardware is the culprit. Does this sound like what you went through?

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Rodney, I have lateral calf numbness since my tibial plateau surgery which was repaired with plates and screws. I empathize with discomfort with flexing the calf. It could be the plate or the screws. I think the best thing is visit the surgeon again and let him X-ray the leg. Hardware can migrate and become misplaced. I frequently get Charlie horse’s in my calf since the plate was placed and it always happens when I’m sleeping

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@pegleg27

I had My surgery last July after a traumatic injury from jumping into shallow water to rescue my Granddaughter. I have A plate and five screws and also had a high grade strain to the Lis Franc in my foot. Now I seem To have some type of nerve pain the runs between the foot, knee, hip and buttocks. I am So uncomfortable and wondering if the hardware could be pinching a nerve. It seems to be getting worse instead of better and I’m going on one year since the injury. I am Wondering what the recuperation is like after hardware removal bc I spent Last summer in a wheelchair and not looking forward to that again. Do you have to start all over again after hardware removal?

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Wow, I am having the same issue. Surgery with a plate and 6 screws a few years ago. Was told it went well and initial recovery was pretty good EXCEPTfrom the moment I could finally put weight on the leg I notices some discomfort where the thigh meets the trunk. Docs and PT pretty much ignored this! By the way, although I was told the surgery went well, the bones were absolutely not perfectly aligned as my calf is ever so slightly bowed and my foot turns in slightly. Not noticeable to others. And when I lay on my back and straighten the leg, when the leg gets halfway, it does not stay straight the rest of the way, but rather turns inward. Now its been a few years and suddenly I am having problems. Pain off and on exactly the length of the plate and on and off in foot, knee, hip and buttocks/lower back. I wondered if the plate or screws had come loose but it doesn't appear to be the case. I too am wondering if the plate is pinching something. Tho I am also concerned it is all due to slight misalignment.

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@abruby

Wow, I am having the same issue. Surgery with a plate and 6 screws a few years ago. Was told it went well and initial recovery was pretty good EXCEPTfrom the moment I could finally put weight on the leg I notices some discomfort where the thigh meets the trunk. Docs and PT pretty much ignored this! By the way, although I was told the surgery went well, the bones were absolutely not perfectly aligned as my calf is ever so slightly bowed and my foot turns in slightly. Not noticeable to others. And when I lay on my back and straighten the leg, when the leg gets halfway, it does not stay straight the rest of the way, but rather turns inward. Now its been a few years and suddenly I am having problems. Pain off and on exactly the length of the plate and on and off in foot, knee, hip and buttocks/lower back. I wondered if the plate or screws had come loose but it doesn't appear to be the case. I too am wondering if the plate is pinching something. Tho I am also concerned it is all due to slight misalignment.

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I had a hip replacement and the surgeon didn’t set the ball part right so it kept dislocating. I’d rather have natural childbirth the pain was so bad. Had a revisionist check it out. Got infections and had to keep having fluid drawn out. When all that cleared he took out the old and put new one in. Below my knee is now turned in like knock knee and shin is bowed. This was 4 or 5 years ago. I haven’t had any problems yet. May have something to do with cracking my femur when putting in the new and having to wire it in. I notice that I’m off balance a lot, that may be the reason. I would question your surgeon. Even a second opinion if needed

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Hi All - I had a plate and 3 screws removed 2 weeks from the outside of tibial plateau. I am having charlie horsing in my thigh, shooting pain down my shin, pain around the patella. Has anyone else had the plate removed and had this kind of pain 2 weeks out from surgery? How long until regular, painless activity? I walked 5 miles 2 days ago it didn't hurt while walking, but today, I can barely walk. I'm a 55yo athletic female with good bone density.

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Hi I had an open tibial pilon fracture in 2014. At the moment I have 3 plates and screws one very near the articulation itself. I have límited movement specially in the mornings. After 3 years of thinking and being very afraid I am getting 4 screws removed. I hope Ill have less pain and more mobility.

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Anemarie. I'm wishing you well on the screw removal and hope it alleviates your pain. No one should live in pain. No one.
They wanted to do a PFO closure on me (close the congenital hole in my heart exacerbated by Covid vaccine) and I said no. What happens if I'm allergic to the device.? What happens when my scar tissue starts forming layer upon layer until it's too heavy and you have to take the device out? I've READ what happens 😳. I'll take my chances. After lasik eye surgery that went awry, I decided not to change anything that I was not born with or in this case, born "with"!
Where are they taking the screws from? Where are you having it done? I'm just asking out of curiosity as I'm always interested in different kinds of procedures, especially those that would alleviate pain.
Good luck to you!!

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@anemarie

Hi I had an open tibial pilon fracture in 2014. At the moment I have 3 plates and screws one very near the articulation itself. I have límited movement specially in the mornings. After 3 years of thinking and being very afraid I am getting 4 screws removed. I hope Ill have less pain and more mobility.

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@anemarie Hello and welcome to Connect. May I ask what your fear is regarding removal of surgical hardware screws? I can tell you from experience that recovery from surgery for hardware removal isn't as bad as the surgery that gave you that hardware, and if your fracture was healed, you should be able to move as well as you do now after removal. After a few weeks of discomfort from annoying stiches, when those come out, you'll feel better. My hardware caused me pain. It throbbed and my leg would get warm. It was developing slight pigmentation on the skin over the plates. I also had chronic hives for months until it came out and I had to stay on antihistamines all the time.

Surgery does create scar tissue, and that can cause pain because it links the scar on the surface to the operative site inside your body. You can stretch out the scar tissue with myofascial release to get movement back. Sometimes that tight tissue does affect mobility, and that would be a question for a physical therapist who does this type of therapy. I do MFR and it helps a lot. Sometimes mobility issues are muscle weakness from the result of the injury, and that can take years to get back. I am 2.5 years past my ankle fracture injury, and still working on strength, but it does slowly get better. I have heard it may take up to 6 years to build back strength to be close to pre-injury ability.

Here is our myofascial release discussion:

MFR — Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/.

There is a provider search at http://mfrtherapists.com/

Do you have hardware removal scheduled? Will some hardware be left behind when the screws are removed? Did you discuss removal of all the hardware with the surgeon? If I had left any of it in my leg, I would still have pain. My body doesn't like living with metal inside.

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@jenniferhunter

@anemarie Hello and welcome to Connect. May I ask what your fear is regarding removal of surgical hardware screws? I can tell you from experience that recovery from surgery for hardware removal isn't as bad as the surgery that gave you that hardware, and if your fracture was healed, you should be able to move as well as you do now after removal. After a few weeks of discomfort from annoying stiches, when those come out, you'll feel better. My hardware caused me pain. It throbbed and my leg would get warm. It was developing slight pigmentation on the skin over the plates. I also had chronic hives for months until it came out and I had to stay on antihistamines all the time.

Surgery does create scar tissue, and that can cause pain because it links the scar on the surface to the operative site inside your body. You can stretch out the scar tissue with myofascial release to get movement back. Sometimes that tight tissue does affect mobility, and that would be a question for a physical therapist who does this type of therapy. I do MFR and it helps a lot. Sometimes mobility issues are muscle weakness from the result of the injury, and that can take years to get back. I am 2.5 years past my ankle fracture injury, and still working on strength, but it does slowly get better. I have heard it may take up to 6 years to build back strength to be close to pre-injury ability.

Here is our myofascial release discussion:

MFR — Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/.

There is a provider search at http://mfrtherapists.com/

Do you have hardware removal scheduled? Will some hardware be left behind when the screws are removed? Did you discuss removal of all the hardware with the surgeon? If I had left any of it in my leg, I would still have pain. My body doesn't like living with metal inside.

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Thank you so much. Your experience calms my anxiety. My fear is infection and always will be infection. Today I talked to the doctor ( in Chile) I am being operated in Chile. He said no wheelchair, no crutches.
He will remove 2 lateral distal screws and on fibula: 1 distal medial screw, and the last one of the medial plaque( on my fibula) . Básicamente the doctor is removing the last 2 screws on fibula and las two screws on tibia.
Thank you again

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