Should I have Tibia Hardware Removed after Healing?

Hello. I am completely new to this website. I don't do many things online at all. But I am recovering from a tibia plateau fracture type 2. I had surgery for this and I have a metal plate and screws. I am five and a half months out from my surgery. I have made a lot of progress. At home I don't use anything to walk around outside I use a cane. But I have a very deep curiosity about if I need my plate removed. I walk kind of crooked. It's not a regular limp it's not that I'm in pain but I feel that the plate is over to the left side too much and like it's heavy and interfering with me walking straight. I'm very mobile the physical therapists are so amazed that my flexibility but yet I walk crooked. I'm wondering if anybody else has had this problem almost 6 months after their surgery. So of course I'm thinking about plate removal. I haven't discussed this with my doctor yet. But if anybody else has been through something similar please let me know thank you very much

Hello. I am completely new to this website. I don't do many things online at all. But I am recovering from a tibia plateau fracture type 2. I had surgery for this and I have a metal plate and screws. I am five and a half months out from my surgery. I have made a lot of progress. At home I don't use anything to walk around outside I use a cane. But I have a very deep curiosity about if I need my plate removed. I walk kind of crooked. It's not a regular limp it's not that I'm in pain but I feel that the plate is over to the left side too much and like it's heavy and interfering with me walking straight. I'm very mobile the physical therapists are so amazed that my flexibility but yet I walk crooked. I'm wondering if anybody else has had this problem almost 6 months after their surgery. So of course I'm thinking about plate removal. I haven't discussed this with my doctor yet. But if anybody else has been through something similar please let me know thank you very much

Hi @don34, Welcome to Connect. My wife has a plate and screws in her ankle and wrist from two different falls. At one point she asked the surgeon about removing the hardware from her ankle but since she wasn't having any problems the surgeon suggested leaving it in because there is always risk with any surgery and a possibility to make things worse. I think it is a great discussion to have with your surgeon and learn what they feel may be the associated risks and benefits.

Here's some information I found on the topic that may be helpful -- Removing Pins and Other Implants After Surgery: https://www.verywellhealth.com/removing-metal-plates-screws-rods-after-surgery-2549320

I think you have some very good questions to ask the surgeon. I've found that it is really helpful for me to put together a list of questions I have and take them to my appointment with me so I don't forget to ask. If you haven't done this before, you might find this site helpful for formulating questions - https://patientrevolution.org/visit-tools.

Do you have an appointment with the surgeon setup yet to discussion your questions?

Update
I had one of two screws near my knee removed and it totally resolved pain in my knee going up and down stairs. I also had two screws removed near my ankle and the numbness in my foot has improved greatly
I will leave the rod in for fear of further trauma to my knee
I am so glad I had this done and I hope it gives good information to those considering having hardware removed. It’s been two years since my bike accident

@don34 Don, I do not think removing hardware or partially removing it will change anything with tightness and numbness unless your tibia and fibula have been screwed together. That is a discussion to have with your surgeon after you have an opinion from the new specialist and/or a good physical therapist about what is possible. My surgeon would not remove any hardware until it had been in place at least a year, and I was at 16 months post op when it was removed. It takes longer for the ligaments and tendons to heal.

The numbness may be from nerve damage. Sometimes peripheral nerves can heal, but that takes a long time, and can be more than a year. I still have some stiffness in my ankle, but it is not tight anymore and keeping the parts moving correctly helps that a lot. The tightness comes a lot from the muscles on the stronger side beating up the weaker side because they can't counteract the strength. With physical therapy you stretch, but also need to rebuild strength on the weaker side as best you can. My difficulty with that was walking on uneven ground and having to stabilize my ankle in mud when I was out doing horse feeding chores. I was doing the least amount of steps as possible and getting a lot of fatigue and pain. It was a long winter being careful on ice and snow, then the months of mud in the spring and frequent rains. I wasn't sure how long this recovery can be to get back to my maximum recovery and my podiatrist couldn't really answer that either as it must vary with a lot of individual factors. I have wondered if it could be as much as 5 years.

I am encouraged and happy about my recent advances just in the last few weeks without the brace and want to try walking and hiking more to build endurance. What I can tell you is that when you have a high impact fracture with some added speed from a bicycle or moving horse, it tends to be a worse fracture. Mine was what they call a bimalleolar fracture, in simple terms, the "knobs" on both sides of the ankle (formed by the tibia and fibula) were sheared off. The front of my tibia was like puzzle pieces because of compression of flexing my foot into the ground on impact. If your surgeon were to remove hardware, he may not want to leave some of it there, and there is a reason there are at least 3 screws with plates so they can't move; he would probably remove the entire plate instead of leaving too few screws in place. That could also depend on how difficult it is to remove. The tricky part on mine was a screw inside my fibula, but he did get it out. The plates screwed to the outside of the tibia were easy to remove.

Knee problems come when you have alignment problems in your leg because something changes and you start walking differently. MFR therapy can help a lot with body alignment and more normal movement. If you get any pain in the knee, talk to a physical therapist or specialists about it, because if it is left alone, it can lead to uneven wear an tear, and this is what causes problems that can lead to knee replacements. It is possible that surgical hardware can limit your movement and lead to other joint problems, so do ask that question if that could happen to you. The recovery after hardware removal was not nearly as hard as the recovery right after the injury, so don't let that influence your decision. I'm thinking it seems to be about half the time at least in my case.

Second opinions are good. Would you let me know what you find out? I think I can help. Would you like to talk about the fear?

@mybrokenbones Hello and welcome to Connect. I'm sorry you've had 2 ankle fractures. That is a tough injury to overcome. My fear of medical issues and surgery didn't come from my fractured ankle. I had a deep rooted fear for many years, and when I went through spine surgery, I addressed my fears and figured out the source, and deprogrammed it. When I broke my ankle, it was from a fall from a horse that bolted. I didn't know I was falling until I was on the ground. It wasn't my horse. It belonged to a friend and we had gone out as a group trail riding and it seemed OK, but she was a little green, and spooked easily, but then she was over it. The problem was a loose dog came up behind and chased her. All the horses in our group spooked for that.

I didn't have fear in falling because I didn't know I was falling. I had an old horse who was not sound for the trip and really couldn't be ridden anymore. After recovering from my injury, I bought a new younger horse. I wanted a horse I can bond with an communicate with and I work on that all the time. He is super smart and very sensitive, so I tread lightly in my movements. I also always wear a helmet and work boots with toe protection. I learn as much as I can about communicating with and training horses and have gone to some training workshops. I feel this gives me the safest way to ride, and if the horse is nervous, I get off.

You do have to ask yourself why you have fear, and look for past experience that feeds into this fear. It may take a lot to unravel, but it is worth it. Your recent injury could have caused fear, but it also may have triggered something in your past when you were not in control.

@jenniferhunter Thank you for sharing your experience. I cannot imagine how scary to break an ankle falling like that. Definitely one of my fears! I think you are are correct about my current fear coming from recent injuries. I was riding a green horse last year, one of my own. I am very careful and slow, and I had been riding this horse for about 2 years, 4-5 days a week. She was started late in life, but I kept her because she is so calm and level headed for the most part. We were not doing anything crazy, just a jog in the round pen. I must have missed something because I just remember being in the air and she was bucking. She's never bucked before, even when she was started. It wasn't a spook either. I was on the ground quickly and landed on my shoulder tearing my AC joint. This injury shook all my confidence, and I still cannot ride the horse. I had to work all summer to regain my strength and be brave enough to ride again on different horses. I had someone ride my horse for me regularly all summer and she never had any more issues, so I still don't know what happened for sure that day. My suspicion was that it could have been caused by pinching from a recent chiropractic visit that didn't get to the actual problem and created soreness. But I will never know.
I was just getting brave enough to face my fears and start over when I broke my ankle in France this summer. Now I can't walk and I don't know where to begin on healing the mental part from these injuries.