Hardware removal - extremity

Surgeons use hardware such as pins, plates, or screws to help fix a broken bone, torn tendon, or to correct an abnormality in a bone. Most often, this involves bones of the legs, arms, or spine.

Later, if you have pain or other problems related to the hardware, you may have surgery to remove the hardware. This is called hardware removal surgery.

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Description

For the procedure, you may be given medicine to numb the area (local anesthesia) while you are awake. Or, you may be put to sleep so you do not feel anything during the surgery (general anesthesia).

Monitors will keep track of your blood pressure, heart rate, and breathing during the surgery.

During the surgery, your surgeon may:

Open the original incision or use new or longer incisions to remove hardware.
Remove any scar tissue that has formed over the hardware.
Remove the old hardware. Sometimes, new hardware may be put in its place.

Depending on the reason for the surgery, you may have other procedures at the same time. Your surgeon may remove infected tissue if needed. If the bones have not healed, additional procedures may be done, such as a bone grafting or new fixation.

Your surgeon will close the incision with stitches, staples, or special glue. It will be covered with a bandage to help prevent infection.

Why the Procedure Is Performed

There are several reasons why hardware is removed:

Pain from the hardware
Infection
Allergic reaction to hardware
To prevent problems with growing bones in young people
Nerve damage
Broken hardware
Bones that did not heal and join properly
You are young and your bones are still growing

Risks

Risks for any procedure that requires sedation are:

Reactions to medicine
Breathing problems

Risks for any type of surgery include:

Bleeding
Blood clot
Infection

Risks for hardware removal surgery are:

Infection
Re-fracture of the bone
Nerve damage

Before the Procedure

Before the surgery, you may have x-rays of the hardware. You also may need blood or urine tests.

Always tell your health care provider what medicines, supplements, or herbs you take.

You may be asked to stop taking certain medicines before your surgery.
Ask your provider which drugs you should still take on the day of your surgery.
If you smoke, try to stop. Smoking can slow healing.
You may be asked not to drink or eat anything for 6 to 12 hours before surgery.

After the Procedure

You should have someone drive you home after the surgery.

You will need to keep the area clean and dry. Your provider will give you instructions about wound care.

Ask your provider when it is safe to put weight on or use your limb. How long it takes to recover depends on whether you have had other procedures, such as a bone graft. Ask your provider how long it may take to heal so you can resume all your regular activities.

Outlook (Prognosis)

Most people have less pain and better function after hardware removal.

References

Baratz ME. Disorders of the forearm. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 8h ed. Philadelphia, PA: Elsevier; 2022:chap 21.

Kwon JY, Gitajn IL, Richter M. Foot injuries. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 67.

Rudloff MI. Fractures of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 54.

Review Date: 9/20/2022

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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