Remove/keep hardware.

[d123 1]

Almost 2 years ago I've busted my tib/fb and got some hardware inside - my inner shine as I call it - that reminds me now and then that the weather changes.
Don't get me wrong I'm pretty active with my ankle long boarding, running, etc with no pain - if I do my warm up.
My doctur recommended to keep the hardware for life ... but I'm looking on the other side now and I'm wondering if the grass its more green there...
I would love to hear anybody who has hands on experience with removing hardware or re-injure while the hardware was inside.

Thanks,
Jean-Arthur Deda.

Lock, Dock and Two Smoking Barrelrolls!

[MTGirl 2]

I've seen a couple of posts in regards to this and thought I would offer my professional two cents.

I work in physical therapy and am quite familiar with this kind of recovery. I can honestly say that the amount that I have seen hardware removal is only about 50/50. From a recovery stand point it really hasn't made any difference in the overall outcome UNLESS you have continued pain or other problems. Removal of hardware is also dependent on where exactly it's located. For example, some patients have to have the hardware taken out because it impedes ankle mobility, but was necessary to have in the first place so that the bones would heal back together. On the flip side, I've had multiple patients who have never had the hardware taken out and they have been just fine. The circumstances are purely individually based.

Keep in mind, if you choose to have the hardware taken out, it involves another surgery with recovery time. IMHO, if the hardware isn't bothering you I don't believe there is any point in opening you back up to take it out. You might even be hard pressed to find a surgeon who would be willing to put you under the knife without due cause. Pain experienced in a joint with weather changes is most likely due to change in barometric pressure and to be honest, you will probably notice that with or without the screws and plates.

If you notice increasing pain in the future, definitely go back to your surgeon and have them check you out. It is possible that down the road they would want to do something about it. But who knows, you might also only continue to get better yet with time.

Good luck with whatever you decide to do!

P.S. It took my broken foot to stop sensing change in the weather 5 years after it healed...and that was without surgery.

[d123 1]

I see what you mean! I will feel exactly the same with no hardware.
I guess from here with age it will only get worse .... how typical for life

Anyway, thanks for your time and for the explanations.

Lock, Dock and Two Smoking Barrelrolls!

[tigra 0]

OK, NOT a medical professional but I did have 2 tib/fib fractures with hardware and I had ALL of the hardware removed. It made a HUGE difference. The 2nd time around, I didn't even realize how much the hardware was bothering me until it was removed. Even when I was still swollen and sore form the surgery, I felt relief. And this was just a plate and screws on the fibula side.

The first time around, when I was still healing and before I had time to think much about it, my OS suggested that I would want everything removed within two years. His logic was that I was relatively young, healthy and active and I would see a benefit from hardware removal. Also, he said bone doesn't grow where the metal is but will grow back once it is removed and bone is better than metal in the long run. Well, as soon as the cast was off and the swelling went down, the screws in my fibula were visible and the ones deeper inside my tibia were painful- talk about a barometer! He took everything out a little over a year after the break and the "barometer" in my ankle went away and I regained probably 99% of my ROM. Its been almost 10 years and if I didn't have the scars, I wouldn't know I broke it.

2nd time around, I had "temporary" screws that had to come out and when he took those out, I begged him to remove the vertical screws in my tibia because they felt like railroad spikes driving up into my leg with virtually every step I took. It was a different doctor and he thought it was too soon to remove everything but when he checked the Xray, he decided my bone had healed enough. He left the plate and screws on the fibula side, but I ended up having them taken out 18 months later.

Bottom line- for me- hardware removal made a HUGE difference. The 2nd time around, I was getting by OK with the plate and screws in my fibula, but I could still feel it. Its kind of funny, because that doctor initially really didn't think hardware removal would make a big difference and when I went for the follow up visit post surgery and told him how much better my ankle felt, his comment was "I'm not surprised, those screws were digging into your nerves and tendons!" He really changed his tune.

Oh yeah, and no trace of arthritis in either ankle! I started working out pretty regularly about 18 months ago and at first, the more recently injured ankle (2003) bothered me a little bit but now that its better conditioned, there's no pain, no limitation I can see at all.

[repcool 2]

I had a nail put in my femur 6 years ago from a snowboard wreck that shattered it badly. I also lost the nerve right around my knee and that caused drop foot. I did some hardcore PT and got back into half marathon shape. I concluded that it was good enough to keep but honestly I was in pain so much of the time.

Last year I finally decided to have it out, maybe I just wanted the sympathy vote for having surgery...:-) Really the operation was a piece of cake. I was walking right away, jumped a few times within 6 weeks and had an awesome ski season. I now kind of regret not getting it out before, but I know for next time. I did take advantage of some decent health insurance, I wouldn't of been prepared to cough up too much cash for it.

Hope this helps, no advice to give as such, but this was my experience.

[d123 1]

Thanks for the feedback! It's highly appreciated.

Lock, Dock and Two Smoking Barrelrolls!

[d123 1]

As a follow up to this thread I have to say that I'm considering removing the hardware in the late fall/beginig of winter.

As a tip to everybody who has fucked ankles (sprain or dislocated) from a guy who has hands on experience on the matter is to do running and later sprint running. Don't be a sissy and put up with the temporary pain .... after a while you'll break into the confort zone and beasides the ride is the motivation!

Thanks guys for all the good inputs!
Be there and be safe!

Lock, Dock and Two Smoking Barrelrolls!

[brianfry713 0]

I had a busted fib/dislocated tib B.A.S.E. jumping and got a plate and 6 screws to keep it together. The doc seemed to go back and forth about whether I should keep it in or not, eventually he said I should get it pulled because he used a big plate and it would bother me if I didn't. My last surgery was in January and I'm pretty much healed now. I can still feel it but I can run and jump now.

I would go with the doc's recommendations, if you don't like them then get a second or third opinion from someone qualified.

I'm guessing (I'm no doc) it would depend on the injury, the healing, the type of hardware, and probably other things. My girlfriend still has a rod inside her tibia and she might keep it for good, or maybe get it pulled out, it's been around 7 months for her so far and she's still limping.

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[monkycndo 0]

I have a plate and 6 screws in my fib. The only time it bothers me is when my boots rub the muscle/skin against the screw heads. When I finally get fed up, and it's not jumping season, the doc said he would take the screws out. Followed by 2 months restricted activities for the screw holes in the bone to heal.

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[AllisonH 0]

Quote

I'm guessing (I'm no doc) it would depend on the injury, the healing, the type of hardware, and probably other things. My girlfriend still has a rod inside her tibia and she might keep it for good, or maybe get it pulled out, it's been around 7 months for her so far and she's still limping.

This is probably a dumb question, but I've always wondered... How do they take out rods they put inside the tibia?

[brianfry713 0]

Her rod will probably stay in unless it needs to come out. On one hand it would be bad if she had another bad landing and broke the leg again with the rod inside, so she might get it pulled for that reason, or we'll just wait and see. On the other hand it's another surgery and recovery and may not be necessary. Right now the concern is just to get the bone to heal with the rod inside.

According to her, they just pull all the screws out and then it'll slide out the way it came in, through the knee. I'm sure they have a procedure that may entail using a screw hole at the top of the rod to pull on and some way to anchor the leg.

BASE 1224, Senior Parachute Rigger, CPL ASEL IA, AGI, IGI
USPA Coach & UPT Tandem Instructor, PRO, Altimaster Field Support Representative

[DrewEckhardt 0]

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Keep in mind, if you choose to have the hardware taken out, it involves another surgery with recovery time. IMHO, if the hardware isn't bothering you I don't believe there is any point in opening you back up to take it out.

While painful and distrurbing to see something like ankle joint, knee joint, between joint? long bone shaft breaks without complications can be repaired to restore normal function.

When the ends break, people end up with arthritis which isn't fixed with surgery.

The thinner shaft of long bones like the tibia is a fuse that makes the repairable injury more likely.

OTOH, with an IM nail the shaft may no longer be the weak point and re-injury could be much worse.

I'll get my tibial nail out once the bone graft has time to heal for that reason.

[ZigZagMarquis 8]

I broke my tib & fib badly back in 1998 on a bad landing and ended up with 8 screws and a plate to put it all back together. I had about 900-and-some jumps back then. I was grounded for 6 months. Did some jumping with the hardware still in there, but had it removed just shy of a year after the original injury because I didn't want to re-break it with the hardware still in there. I was out for about another 6 weeks after the second surgery... probably should have been longer, but there was a 10-way competition that came up that I wanted on... . Anyway, here, 10+ years later, my ankle is still not 100%, never will be, and lets me know it, but I think that more to do with the original injury and not my decision to have the hardware removed. I deplore running and use this as an excuse not to... ... but still exercise else wise... bike, weights, elliptical, etc.

[Brains 2]

Quote

This is probably a dumb question, but I've always wondered... How do they take out rods they put inside the tibia?

I saw a video of this that someone posted on facebook and i wish i hadn't. They open up your knee to expose a part of the rod, attach a slide hammer to it and start beating on it in an upward motion to remove it from the inside of the bone. That is why both of my Tibs still have a rod in them!!

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