Removal of plate and screws from tibia fracture

Posted by tc125 @tc125, Oct 30, 2018

Hello, I broke my tibia in April 2018 and had surgery to insert a plate and 9 screws. I have pain walking every day all day. The surgeon has recommended having the plate/screws removed. I am reluctant to do it because the surgeon said he can't guarantee the pain will be gone. I'm not sure if it would be worth it to have incisions, remove screws, slide the plate out, have anesthesia and get stitched back up. I was wondering if anyone has experienced this type of surgery and if so, was it worth it.

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@cgavin61

I happened upon this site looking for others that have experienced what I am experiencing. On June 17 of this year I fell and broke my tibia. Had two surgeries,
external and internal fixation with Plate and 8 screws. It’s been six months and I am in pain every day. I have what looks like a screw protruding out my leg. I go back to my doctor this week for consult and X-rays. The thought of another surgery is very discouraging and I don’t even know If removal is an option yet but I wanted to see how long your recovery was with the removal and if you are still doing well. Thanks so much for sharing.

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Your situation sounds very similar to mine. I broke my tibia exactly a year after you (June 17, 2020) and also had an external fixator before having surgery to have 2 plates and 12 screws put in my leg. I've been in constant pain and my PT doesn't know what else to do, so my surgeon is going to remove my plates and screws next Monday. While I'm scared to have another surgery done, I'm praying this will be the solution to stop the pain! 🙏

Have you been able to get yours removed yet? Hope you're doing better!

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@caligirlian

Hi, I’ve read many of the discussions on the forum about tibia plateau fracture‘s that people have had. I wanted to share and get some feedback from those that have had the same issue that I have been experiencing since my accident.

In 2018 I had an accident and tore my meniscus and fractured my Fibia and broke my tibia and had an external hardware attached to my bone on my left leg. My orthopedic surgeon replaced hat with internal hardware that consisted of 12 screws and a plate.

After, three months of laying around with no weight bearing on my leg I begin PT then had 50% weight bearing on my leg in January 2019. It wasn’t too bad I thought I was getting better and making progress. I used a walker and crutches to get around and felt I was gaining muscle and stability again.

But, after 10 months of PT I got frustrated because I really worked hard at gaining muscle and strengthening of my leg and it just hurt and didn’t want it to hurt. Was taking pain meds for awhile but again tried to strengthen my leg. I was seeing progress but continual pain.

I said I needed to get the hardware out of my leg because it was hurting so much under my knee were all those screws were in bedded. The plate was just as bad as it continually pressed against my bone and tendons. I thought OK this will be great I can get this internal hardware taken out and I’ll feel much better and continue gaining muscle and strengthening my knee and leg.

Well its August 2020 I had my internal hardware removed. At first it felt great getting the screws out of my leg and I definitely felt the difference for the first couple of weeks and believe that all that pain from the screws & plate was going away.

As of today September 16th after I got my stitches removed I had 30 staples with my first surgery and I had another orthopedic surgeon take out the hardware this round so he put stitches there instead. The scar looks like an upside down hockey stick. But at least my scar is Looking better again every day Like it did before the second surgery.

My complaint is I still have pain on the side where the plate was and underneath the knee where the screws were. It has been stiff for a while which that’s gone away some more but I don’t like the feeling at all. I do stretch my leg and bend it more and it looks pretty good you were to see it no one would believe I even had a problem. But, after months and months of swimming and stretching which help some, the pain doesn’t go away.

We’re a month out post surgery with taking the internal hardware out but wondering if it’s going change for the better and become more “normal”? Or will I always have this pain? I’m thinking of getting a shot which will lubricate the knee helping it become less sensitive.

Does anyone have some experience from removal of internal hardware? What happened and how are you coping.

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Hi Cali. I broke my tibia on June 17, 2020 and like you, I first had an external fixator then 11 days later, I had 2 plates and 12 screws put in. No weight bearing for 3 months, then just 15% for more than a month. I had an in home PT for 4 months then was finally able to go to outpatient PT in the middle of October. Almost 9 months later and I'm still in constant pain! Everything in my leg just feels weird and heavy! So my doctor will be removing my hardware this coming Monday. I'm really scared about going through another surgery but he said it'll be done as an outpatient and I'll be waking out of the hospital this time.

Now that you've had yours removed for a while, how are you doing? Are you still in pain? Do you regret getting the hardware removed? Any other problems you can share?

Thanks so much!

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In 2014, I jumped off a catamaran in Hawaii onto the beach and my right foot landed first. I got what they call a “distal tibia fracture” which is a diagonal break of the large shin bone and it was just above the ankle joint. My ankle was dislocated but it was reset and the joint was clean. I flew home to NC and had surgery within the week where I was fixed with 19 screws and 2 plates. I was about 30 years old so now I’m 38 and I am active in martial arts and athletic. I run every day and I spar and kick people a lot with that leg and foot. But it hurts with normal use. There is a throbbing inflammation feeling I have on a regular basis that is in the soft tissue and the bone. As a carpenter I remember seeing the X-rays of my surgery for the first time and exclaiming “where’s the screwing pattern??” Every screw is angled and in a different direction and I can feel that fact when I walk too long or have a long day on my feet. It has never “gotten worse” because pretty much from day one (when I started walking again a year after my surgery) it has been the same easy pain and throbbing soreness. I made an initial request with the same surgeon at mission hospital about removing the hardware and he said “oh I wouldn’t do that” when he had initially said “it can be removed later of course…” he felt uneasy I think about tissue healing between scars or something. I understand, but I also am annoyed that he spoke out of both sides of his mouth. I am now kind of afraid I may never get to take it out and would love to hear if anyone has a similar experience but has removed so long after surgery (8-9 years?) with a lessening of pain. Also what does that cost? I’m in at least all three kinds of pain which plates and screws can cause that I’ve read about (local soreness, sub-skin irritation from metal rubbing, and bone and joint throbbing) and I would love to finally recover once and for all. I feel like keeping it can only get worse with age and arthritic pain in the joints is already starting. I already feel at night like my lymphatic system is on overload in my knee and hip on that side (not to mention my constant battle with crazy spine alignment from subliminal compensation over the years). Anyone please help!

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Wow! Good luck with recovery with that. You have several issues you are addressing. The bottom line is you are probably going to hurt as you age. However, there are some strategies you may try. The first strategy is to ascertain how you are healing. Ask your physician or an Urgent Care physician for an order for a blood panel to evaluate your RBC's & WBC,s to see if you have elevated WBC's which may show some sign of infection or other reasons that may indicate why you are healing to slowly, if that is the issue. Also mechanical parts in our body can collect bacteria and or fungal infections and a blood culture can spot and rule out these issues. By requesting an order from an Urgent Care, they can write a prescription (order) for $150 and you cant take it to LabCorp or Quest Diagnostics who offer cash deals. This lowers cost for insurance and out-of-pocket costs, if you have a high deductible plan. I had two C-sections as a younger woman and it took more than 10 years to stop hurting and another 10 years to stop itching. After studying nursing, I discovered some techniques that I could have incoporated during the healing process to heal more quickly.

Incorporate a good vitamin regimine to increase your body's ability to recover. Not all vitamins are equal, make sure you get a prescription for those vitamins as some benefit plans cover vitamins, if ordered by a physician. Make sure you are utilizing all of your financial strategies efficiently, especially if you are self-employed. Ask an accountant about HSA's, FSA's and other IRS medical tax deduction accounts that you can incorporate, especially if you are not employed with a corporation.

Finally, seek a second opinion from one of those sports orthopedic physician groups. My orthopedic doctor gave me Diflucenac and prescribled arthritis strength Tylenol for swelling and joint pain due to aging and workouts at the gym. He advised me that I needed to change or modify my exercise routines based on the fact that I am older and cannot do what I used to do anymore. Like you, I haven't listened and I still exercise the way I used to, but I have made some modifications.

If you are a finish carpenter, then you are an artist and need to consider a new way to earn a living, which also satisfies your creativity. There are lots of other careers that you may find rewarding that will incorporate your creativity. See a professional job counselor to help guide you. Try your state Voc Rehab office, which may pay for training and education.

Best regards

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@sarxweh

In 2014, I jumped off a catamaran in Hawaii onto the beach and my right foot landed first. I got what they call a “distal tibia fracture” which is a diagonal break of the large shin bone and it was just above the ankle joint. My ankle was dislocated but it was reset and the joint was clean. I flew home to NC and had surgery within the week where I was fixed with 19 screws and 2 plates. I was about 30 years old so now I’m 38 and I am active in martial arts and athletic. I run every day and I spar and kick people a lot with that leg and foot. But it hurts with normal use. There is a throbbing inflammation feeling I have on a regular basis that is in the soft tissue and the bone. As a carpenter I remember seeing the X-rays of my surgery for the first time and exclaiming “where’s the screwing pattern??” Every screw is angled and in a different direction and I can feel that fact when I walk too long or have a long day on my feet. It has never “gotten worse” because pretty much from day one (when I started walking again a year after my surgery) it has been the same easy pain and throbbing soreness. I made an initial request with the same surgeon at mission hospital about removing the hardware and he said “oh I wouldn’t do that” when he had initially said “it can be removed later of course…” he felt uneasy I think about tissue healing between scars or something. I understand, but I also am annoyed that he spoke out of both sides of his mouth. I am now kind of afraid I may never get to take it out and would love to hear if anyone has a similar experience but has removed so long after surgery (8-9 years?) with a lessening of pain. Also what does that cost? I’m in at least all three kinds of pain which plates and screws can cause that I’ve read about (local soreness, sub-skin irritation from metal rubbing, and bone and joint throbbing) and I would love to finally recover once and for all. I feel like keeping it can only get worse with age and arthritic pain in the joints is already starting. I already feel at night like my lymphatic system is on overload in my knee and hip on that side (not to mention my constant battle with crazy spine alignment from subliminal compensation over the years). Anyone please help!

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@sarxweh Have you considered getting a different surgeon's opinion about hardware removal? Perhaps a spine specialist evaluation in conjunction with a referral to an orthopedic surgeon about the hardware would help. A person can develop scoliosis later in life and if your spine alignment is changing, you may want to see what you can do to keep that from getting worse. Years of misalignment and gravity affecting the spine can lead to problems down the road. I am a cervical spine surgery patient and last year, I broke my ankle and became the owner of 2 titanium plates and 7 screws. I had the same throbbing pains you describe and I always felt like I was getting kicked in the ankle. My asthma got worse too and I had chronic hives and had to stay on antihistamines all the time or it came back.

As I write this now, I'm waiting while my incisions heal enough to take out the stitches. I had my hardware removed and instantly the bone pain was gone and my lungs have cleared from the excess phlegm, and there are no hives to be found. I still have pain from the incision, and I have some swelling affecting the joint, but this is not even close to the discomfort I had after the original surgeries for the fractures. This was not a hard surgery to remove the plates and screws and it did not affect my ability to bear weight. I limp a little because of the stiffness and inflammation from surgery 2 weeks ago. One thing to consider is when the hardware is removed, there are holes left by the screw tracks which will put you at risk of a new fracture. My surgeon advised no strenuous activity for at least 6 weeks. My surgeon also commented about there being little bony overgrowth of the hardware after 16 months. After 8 years, your situation could involve bone overgrowth of the hardware which would make removing it harder. It is worth finding out with a consult and some X-rays. If you do have hardware removed, it may take you a much longer time for recovery until your leg would be strong enough to participate in martial arts. You may need some rehab and strengthening while the bone fills in the spaces left by the hardware.

Please don't let your surgeon's attitude scare you. Just find another surgeon you trust to get an expert opinion for your care. Your surgeon is evaluating his risk of doing a procedure he is uncomfortable with. He doesn't want a bad rating of his skills that would affect his statistics of success. It may have nothing to do with you.

Can you explain more about what your crazy battle with spine alignment is about? Are you being treated for this and is there a diagnosis of an issue with your spine?

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