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Broken Ankle Screw and Plate Removal Surgery: Yes or No?

Is a broken ankle screw and plate removal a good idea?

Is a broken ankle screw and plate removal a good idea?

Broken Ankle Screw and Plate Removal: Is It a Good Idea?

I broke my ankle in 2007. After the orthopedic surgeon fixed the fracture with a plate and screws, I asked him if, at some future point in time, I would have to have the plate and screws removed. He said it was up to me.

On the other hand, the physical therapist told me it was a good idea to have them removed because as you get older, they will cause pain and arthritis.

I have been putting off making a decision because, let's face it, who wants to go through another surgery? I decided to do some research to help me make my decision. Read on to learn what I found out.

What I Learned

I read that, in some cases, when screws were left in the leg, one or two wormed their way out and started poking through the skin.

Some people leave in the hardware; then, the metal messes up the bones years later, causing problems.

Here is one story in which that happened: A friend broke his ankle and left the hardware there. Ten years after the injury, he decided to get it removed because it was causing him problems. Now, he is over 50 years old and can barely walk a mile. He said that the screws did eventually mess up his bones and wishes that he got it removed when he was younger.

I also read that leaving the hardware in actually weakens your bone because the screws break up the bone's mass. The bone can rely on them too much, potentially preventing the bone from growing as strong as it could. I've read this on different websites, so I don't know any of this for fact—just learning from others.

Then I read many stories of people who leave in the hardware without pain or problems. However, how long has it been? Will they stay problem free? This is what worries me. I don't want to wait and then have problems after the damage is done or when I am older and will have a harder time healing.

I think that if I had pain or irritation in the area of my plate and screws, I would have them removed. It would be an easy decision. I am not having any problems, so even though some sites recommend removing them, it's very hard for me to make that decision. I do not feel like going through the pain of the surgery. However, most sites seem to recommend it. So I feel I should talk to a doctor about having them removed. What do you all think? I added a discussion module below so that, hopefully, I can get some help from others.

Here Are Some Sites I Found Helpful—Information and Opinions on Hardware Removal

Image: FreeDigitalPhotos.net

Image: FreeDigitalPhotos.net

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Have You Had Your Plate or Screws Removed? Do You Think You Will? What Did Your Doctor Tell You? Do They Cause You Pain? Why Leave Them? Why Have Them Removed?

Gloria J Woodward on July 07, 2020:

I had a badly broken ankle and they didn't know if they could save my foot or not, but I had a great surgeon and he saved it. That was 3 years ago. For the last 3 or 4 months, it has been hurting and getting worse, but the last time I sen him he said I hope you can keep that plate and 14 screws in there as long as you live. So I was uneasy going in to see him and he ex rayed my ankle and brought the pictures into the room and said just look at this! It is perfect you can't even tell it has been broken except for and the armor it's got screwed into it and I said so what are you saying? He said let's take it out before it starts hurting worse because it will because there are three screws that have worked their way out quite a bit! BUT the best thing is how great your ankle looks and it is totally healed. So there is no reason you should keep it in there. I'm scheduled to have it removed on July 17th at 10:30 am and he said there would not be any pain after the metal was removed. If you would like I can give you an up date as how my surgery went .

DG on December 03, 2019:

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Read More From Patientslounge

I broke my ankle and had a plate and 11 screws August 2108.

I was getting my wound attended to by HITH nurses and was surprised when one of them asked it I had metal in my ankle. I said yes, and she said she could see it. That kind of freaked me out a bit! The bottom 2 stitches didn't seal the wound properly.

Another nurse took a swab and it came back positive for MRSA.

I went to see the surgeon who wasn't happy I'd had it swabbed.I felt ripped off as it wasn't my fault the wound wasn't sealed properly post surgery!

I had to go for a 2nd operation in November 2108, a wound debridement, where one of the screws was also removed.

The wound could finally start healing.

Once the wound healed, I still found I had constant pain in my ankle.

I went to see the surgeon again about July 2019 and was told that some people just react to the metal and I could get the hardware removed whenever I wanted.

I had the metal removed 6 days ago. The post op pain isn't as bad as I thought it would be. I'm being good and staying off it and doing my exercises regularly. Hopefully it's healing well and the ankle will feel better once healed.

Looking forward to not feeling the metal in it!

Franca on June 12, 2019:

I had ankle surgery March 6, 2019 with 6 screws and a plate. Omg the pain is ongoing and often unbearable. Will it ever end? Is this the result of the hardware grinding against soft tissue? It’s really getting on my nerves and I’m ready to blow my brains out. How are you all dealing with the pain?

Suzy Akn on April 12, 2019:

I have seven screws and a plate in my Leg and top two screws are broken off. The Drs. Are reviewing it to decide what to do. How do they remove a screw when the top of it is broken off and the remaining part is in the bone

Nomorestilettos on March 25, 2019:

Just wanted to say thank you to Dawnsantiquesan for posting an opening for discussion as well as thanking everyone for sharing and helping others. I too am trying to decide. I had a tri pin, plate/screws in May 2017 and made a routine recovery with mobility appearing to be progressing with only some slight stiffness when getting going and slight limits being unable to jump at Zumba. I am a Nurse and was happy to go with the opinion of the surgeon which was to leave the hardware alone. However after a year I was accepting that my progress back to full recovery was unlikely but I was at least not worsening and could go about my activities of daily living without significant limitations. Increased use would cause pain in the tibial shaft about 4-6 inches up from the ankle joint itself. No pain in the joint and I’d get slight bruising overnight in the calf muscle along the lower end of the tibia with increased stiffness again for a brief spell. I could feel the end of one nail but it didn’t bother me apart from when choosing shoes so they didn’t catch. I did ask for an appointment to discuss hardware removal but was ambivalent at first. The pain has significantly worsened in the last 6 months which is impacting upon all aspects of daily living causing me to avoid activity, socials, travel and gain weight. I started to read research. Professionally divsed questionaires assess difficulty climbing stairs and omit to assess going down. I have more problems going down so it was a relief when some others identify the same. Professionals take note. Shockingly, one piece of research in 2015 identified a lack of research into the patient’s perspective about hardware removal and found 90% + would do it again and recommend to others. If the manufacturers sell the hardware products on simplicity because it can stay in, but there is a lack of research then I wonder how much suffering isn’t being researched too? I’d be really pleased to hear from anyone who’d be willing to share mores ‘outcomes’ of the “to remove or not remove” decision. Locally, we have a new Orthopaedic Consultant who has offered me an appointment so I go tomorrow. Maybe he read the research ... I’ll try to update this.

Amanda Garcia on August 02, 2018:

Hello all. I read over all the posts and they were helpful, but I wanted to tell my story and see your thoughts. I am a 28 year old female. I was ran over by a car and had Open Reduction Internal Fixation Surgery on my left medial ankle in 8/2011 which resulted in 2 screws and one plate. As a result from the surgery, I got MRSA and then had to get anther I&D (incision and drainage) sugery later in 8/2011 to clear out MRSA. An intravenous PIC line was put in where Vancomycin was administered for a month to clear out infection. This all led me to have a large open wound that I had to keep open post surgery then pack wet to dry with gauze and saline for 2 months until the tissue grew back in. Once wound had closed (which is rather large), I did physical therapy for 4 months after and got most of my mobility and range of motion back. I now have a depressed contracted adherent scar over my left medial malleolus. Althought, the surrounding tissue is supple and mobile, and my left leg peripheral pulses are full. The impression of the scar is poor quality. I saw a plastic surgeon in 2012 concerned of the location of the scar who told me that the scar was over a bony prominence that will be prone to breakdown in the future. He said that light trauma could damage the skin and result in bone exposure. He said it would be easier to remove the scar and resurface the mallelus with a proximally based rotational flap while adjacent tissue is healthy and I am young with good blood supply. Although, he did also say complicatons come with flap coverage which include infection, skin loss, and need for more complex surgery to gain optimum closure. The look of the scar is not what is bothering me. What concerns me is that it is prone to breakdown. Over the last few years there has been swelling on a regular basis within my ankle, especially after working out. I know this is common and did not bother me much until I started to get pain. In past 2 years, if standing on it for a long period of time or engaging in a very strenous activiity, I will have sharp shooting pains that only last a few minutes (which I was fine with and dealt with). I have always been somewhat active but within the past 6 months have become more active than normal. I go to Orange Theory Fitness (interval training cross fit type class) 4 to 5 times a week. I have been doing interval runs at high speeds, but only for short periods of time (anywhere between one minute and 20 minutes). Within last 2 months, I have had a dull aching pain in my ankle that feels constant and is no longer random. Now everytime I do intense weight bearing activity, it aches and then swells after. Since the pain has become so constant, I went to see an orthopedic surgeon yesterday, 3/15/16 (5 years after surgery) to get a follow up XRAY to see if there was any misplacement of hardware or anything he would see immediatly wrong. The surgeon said he does not see much movement of screws, but can feel the back of the screw through the scar, which is okay. He does not think it will puncture the skin in future but can't say for sure. He recommended that I get hardware taken out eventually if I want pain to discontinue, but said its up to me. From what I have read sometimes that does not even happen. He also suggested if I ever got the screws taken out to have him and plastic surgeon work concurrently in operating room to insure that the wound is closed appropriately for best healing because of the poor quality of the scar and all the trauma there has been to that area in the past. I don't know what to do. I am so paranoid I will have a MRSA issue again or I am scared that if I am cut open again, my wound is not going to heal correctly and then I will need more complex surgery to full closure. Please let me know if anyone has had any issue such as myself and what they think I should do. I am sure I should lay off the ankle in regards to intense physical activity, but it is extremely frustrating. Maybe if I did the bike instead of treadmill, it would help a little. But I am assuming I will still get the pain. Thank you

JanineJoyce21@gmail.com on July 13, 2018:

I broke my Ankle and both tibia and fibula in 2009 in my left leg. I have 2 plates and 15 screws. It is July 2018 now. And I haven’t had my plates removed or screws. I just broke my tibia and my fibula in my right leg this time my ankle wasn’t in this surgery. The left leg my bones were all splinter up in my ankle. This time it just the bones right above my ankle. I have 2 plates and 19 screws in my right leg. The pain was bad both times. I actually feel like it’s healing faster. But this time I had blisters everywhere all over my foot and leg. On my left leg that broke in 09. I have 2 screws backing out. Which have been for the past 7 years. The dr on my first surgery in 09 said that I needed them removed in a year. But I never took them out. From being scared. So I’m in the same situation. Not knowing what to do. Thank you so much for posting this. Also my staples are due to being taking out. And it itches so bad all over. Is there a spray or cream that is recommended. I also have been using hemorrhoid spray, because the can says that relives, itching. Burning, swollen skin. Lol but it really works for a short time. And it has 50% witch Hazel in it. I’m guessing that’s an disinfectant. Because it’s sold right beside the rubbing alcohol in the stores. Also Dermoplast my cousin brought me a spray can of it. From when she just has a baby. And it also works good also. So if anyone can. Please give me so advice to decide what I should do also. Thanks again Janine Joyce email: JanineJoyce21@gmail.com.

Laura on May 14, 2018:

Going back to the dr. in July 2018... he advises to get my screw out of my fibula. I'm doing PT myself... and it is stiff, hurts and swells if I'm on my feet for too long. Many people advising me to have it taken out. I watched some youtube videos on the surgery, its going to be in office not out of the hospital. Wish me luck! I'm going for it!

Mirtha on April 19, 2018:

I have my apt in May 3th to remove my screws after 4 months surgery with a broken ankle. I hope that a good decision. I can move on with that pain

Susan on April 01, 2018:

I had broke my ankle in 3 places.2 Plates and 17 screws on both sides of right ankle. I had them removed 9 months later bc of fever. Its been 25 years ago. Im hurting so much from arthritis. Im looking at a possibilty of ankle replacement. Ankle problems have changed me and what I enjoyed doing. Had to quit a job bc of the pain. I would recommend remocing screws and plates though. My fever stopped. Just have had an ugly ankle. Miss my cute shoes.

Mary Flatley on February 21, 2018:

I'm on list to have screws and plate removed after 2 years. dont know if it's right decision

causing me some pain.

Pat on December 16, 2017:

My advice, have your hardware out. I had both ankles with hardware, had it all out.

Darcel on December 16, 2017:

Everything I've read from people who have had the hardware removed is positive, I'm going have mine removed in a couple of weeks. Not looking forward to more surgery but so looking forward to this pain to be done with and getting back to life!

Gonfishin on December 02, 2017:

So I just had my hardware removed on Nov 10,2017.. 3 weeks ago.

All I can say is WOW...why did I wait so long. Just like that, my pain is gone.

As I said before, i broke my ankle Aug 14,2015, a bi-malleolar fracture requiring 2 long screws on the tibia and a plate and 6 screws on the fibia.

After 2 years, I would say there was always a constant pain in my ankle, almost similar to a toothache. At first my surgeon tried to urge me to not get it done, that the pain would go away.. i was quite sure it was the plate causing the pain.

Sure there's risks.. but 3 weeks after removal.. the pain is gone..and I'm looking forward to living with this plate out of my ankle..

Beverly Cameron on November 30, 2017:

My mom b4oke her ankle really bad had to have a rod and a plate pit in. Now after a year or more she complains all the time of it hurting and swelling. She has a weird feeling in bottom of her foot she explains it like a rubber ball. Should she have plate or rods removed. Constantly hurts

Charlotte on November 07, 2017:

I've had mine for 18 years, it's only now causing problems, but after two months i'm begging to have it removed. I've been told it would be classed as elective surgery. I cannot sleep, i'm in pain constantly, using crutches, can't sit for longer than 10 minutes, and they call it elective?!?!?

broke my tibia and fibula in my ankle on July 18th. on October 28, 2017:

Had an infection with stitches on the inside trying to come out. Went on Antibiotics. Then it healed and started PT in Sept 2017 and half way thru October 2017 My ankle started bleeding. This time it became an open wound. I went to a wound specialist trying for it not to get infected. A week after I saw wound specialist, she sent me back to my orthopedic dr. who was out of town and it was a Friday. So Monday I go in and he has already scheduled the OR for me to get plate removed and clean out infection. I was told I had to stay in the hospital 3 nights to get IV antibiotics. BTW Smoking is very very bad if you have an infection.

I am home now and he gave me a boot, to walk with crutches. I can walk without the boot. Was wondering how important is the boot. I had good PT in Sept! Not in any pain except at the end of the day an I take xs Tylenol is all I need.

Tracey on October 09, 2017:

I broke my ankle 10yrs ago, I am I, tons of pain daily, the plates are starting protrude from ankle, I want them removed but my regular Dr won't even acknowledge the problem..

Jason on October 04, 2017:

I also broke my ankle in 2007. Here I am 10 years later and it's starting to cause me pain on a daily basis. I know I'm going to need surgery as I'm pretty sure a screw is starting to back out. I wish I would have done it sooner. Good luck.

Monique on September 27, 2017:

I broke my ankle in 2000 and have a plate and 4 screws on my outer right ankle. Only a few times since then has my ankle ached/throbbed. And seemed to correspond with incoming bad weather. I was told that the hardware would never be removed and could possibly cause arthritis! I’m almost 50 and lately my ankle has been aching pretty badly. I’m told that hardware is fine and would have to put up with the aching; taking Advil helps. Getting old can suck!

Gonfishin on September 24, 2017:

Javier... Sounds like I had the same injury. I had 2 screws on the Tibia, and a plate and 6 screws on the fibia. I broke it on Aug 14, 2015 and was able to start walking Sept 28, by October 12 I was walking with a cane.

The ankle was very stiff for few months.. walking uneven sidewalks and trails were treacherous and the odd ankle twist was painful.. I'd honestly say I was walking very weak up to January.

One year later I would day I'm 90 percent.

Two years now and I'll be getting the hardware removed on Nov 07,2017. For me, the pain is always there. Hopefully the hardware removal will help.

Good luck.

Javier on September 12, 2017:

Hi, I'm 24 now i also break my Left Ankle 2weeks ago I had my surgery 4days after the injury the doc placed a plate and 6 screws in, I'm feeling pains can't sleep at night I still haven't remove the stitches off left with some few day, I face difficulties to rotate my leg I'm afraid my ankle will remain stiff :(, who face the same problem?

Kay on September 04, 2017:

I broke my ankle 3weeks ago I had a conpound fracture I have a plate on the right side and 16 screws it is very pain full and aches alot I got my stiches out last week,y Dr will not me put any weight on it till end of October. I,d like to hear ftom.othets this has happened too.

Samantha on September 01, 2017:

Oh also my primary physician has told me i can & should get the metal removed. They have caused pain on & off for years since 2008 especially if i do not keep 2 VERY GOOD VERY EXPENSIVE PAIRS OF (women's Hoka) SHOES TO ROTATE WEARING THROUGHOUT AN 8 HOUR WORK DAY AND THAT USUALLY ONLY LASTS 5-6 MONTHS TOPS. I swear i could've probably covered the surgery w/ the $$ I've spent on shoes for work so far;) (been at same job 5yrs) So i say yes remove them %100 when you can bc u dont want to risk waiting until its too late or something.

Samantha on September 01, 2017:

I vote you should. Iam actually in the middle of the same predicament myself & reading your story, research, & everyones comments on the subject has helped me make my mind up to go ahead & see if i can get my screws/pins removed from my right heel bone. I have an enormous amount of hardware in my foot from a crushed calcaneus (heel bone for the none medical) that occurred only 1 year after yours..2008. I spent my 21st bday in a cast & everything. Now here iam about to turn 30 having trouble so much so ive had to take a medical leave from work due to an ulser caused from pressure & friction. One of the screws underneath my ankle seems to have shifted so its rubbing up against my tennis shoes from like the inside. This gets especially painful when trying to perform my work duties. I work as a sales floor associate in the house wares dept of walmart so..yea;) It's even started bothering me when iam just at home cleaning doing laundry in my flip flops. I believe the recent pain& aggravation was brought on from a recent car accident i was involved in on 7/7/17 i was cut off while driving to work though i was lucky enough to survive with no broken bones i feel the trauma from the impact has caused me to have more issues than i normally would bc the screw has actually shifted. I say do it while your young so recovery is hopefully swift;) Goodluck!!

Miss S P Davis on August 31, 2017:

I have plates both sides of my leg and screws at ankle joint kinda joining tibia and fibia at the bottom. It's been ten years. I am 51. I get a little pain along the leg and ankle but it bearable. Ankle is always swollen. I get around but can't run. I can live with that. I don't want to risk infection from surgery when they take it all out. How long will it take to heal, will I have more flexibility after so long, how strong will my bones be. Will I still have the arthritis anyway. I think a lot depends on the severity of the injury, how old you were then it happened and your initial treatment to fix it.

Thanks ,but no thanks, I think I will keep my hardware. No surgery for me.

Wishing all the best

NWest on August 28, 2017:

I was talked into it by one dr and talked out of it as I was going into surgery. Within days the screws broke and I can't walk, I have cellulitis. I am a diabetic and very nervous about having to have my foot amputated. I vote for having screws removed. I am so nervous right now as I am going to see another surgeon.

FeelYourPain on August 16, 2017:

I'm a stay-at-home/homeschooling mom of two boys. I was in a freak accident and had a clean break in my fibula, dislocated my foot (it was dangling), and tore up all the ligaments/tendons/etc. I had ORIF surgery on my older sons 3rd birthday, (he's turning 7 in 5 days - which is also the 4 year anniversary of my surgery). They put a metal plate, 6 small screws, and a very long screw that went through my entire ankle (fibula and tibia). It was an extremely long and tough road to recovery, and just like you, I researched hardware removal and the pros/cons. I didn't hesitate to let my surgeon know that I was uncomfortable with it. I requested and scheduled the hardware removal surgery 4 months after my initial surgery. I can tell you without hesitation, that it was the best decision I ever made. With lots of hard work and determination, I was RUNNING again after exactly 1 year! I instantly felt relief when the metal was out. Now I don't have to worry about any issues in the future with the metal.

Surjit Grewal on August 11, 2017:

25 years back, my ankle was fixed with 14 screws, after one year they were removed, now my foot bothers me, standing and walking is painful. I am 72 now.

Flo on August 07, 2017:

I had my steel plate and screws Since 1999 it a long time so I think I should have them remove .

Aida haj ali on August 03, 2017:

I had two screws in my ankle five months ago and i am planning to remove them this september.it hurts when i walk n i could feel the top of the screw with my hand. The surgery as my doctor told me will take ten minutes with three stitches only. I ll post it after the surgery

Lori on July 25, 2017:

Hi everyone I broke and shattered my ankle 10 years ago and 2 of my screws started to come through my ankle so July 19th of 2017 I had all my screws and plate taken out and day 4 I started walking a little at a time and my ankle feels pretty good but empty I don't have any thing rubbing through the skin anymore so this was a good move I made by having them takin out so my advice is if it bothers you please have them takin out thank you for reading this

mikespanier88@gmail.com on July 24, 2017:

This finally decided the question of should I take the 2 screws out of my broken ankle. I had already decided, based on an orthopedic doctor recommendation to just leave them in. But then I heard from a friend, who knows a physician who went in for surgery to have his screws removed . He got an infection from the 2nd surgery and had to have his lower leg amputated. That is the ultimate deciding factor. Do not have another surgery !!!

jbers on July 23, 2017:

My wife broke her ankle in 2008 (nine years ago) and had a plate and six screws installed. After the surgery the surgeon advised her not to have the hardware removed, so she didn't. Understandably her ankle hasn't been 100% and when the weather changed she would have pain. My wife is now 59 years old and for the past couple of years her ankle/foot has been sore all the time and more frequently she is having severe pain,to the point of crying. She recently went back to the surgeon and had it x-rayed, and found that a couple of the screws may be backing out and she has developed arthritis. She was also told that it is possible that the plate could be pinching a nerve. The surgeon told her that removing the hardware may alleviate some of the pain and the ankle would be weak until the bone filled back in, which would take a while since the hardware has been in for so long. She is very afraid to have surgery due to the normal potential complications that can happen with surgery, and doesn't want to unless it's absolutely necessary . She can't go on like this, and while I understand her fears, I'm trying to encourage her to have it removed. For anyone debating to have your hardware removed or not, I would definitely do it. Better to get it over with than to potentially go through years of discomfort and end up having to have it removed anyway.