Surgical removal in selected patients of plates, screws, nails, and similar implants previously placed for fracture or surgical repair.
Indication
- Implant-related pain or discomfort after fracture or surgical repair
- Skin irritation or bursitis caused by a prominent implant beneath the skin
- Suspected infection around the implant
- Implant loosening or breakage
- Implants affecting the growth plate in pediatric patients
- Patient's informed preference (usually 1 year or more after the bone has fully healed)
Preparation
- Confirmation of bone healing by X-ray (usually at least 12 months later)
- Blood tests and ECG evaluation if needed
- Adjustment of blood-thinning medications with physician approval
- Fasting for 6-8 hours before anesthesia
- Cleaning and, if needed, shaving of the surgical site
How it's performed
- General or regional anesthesia is administered by the anesthesiologist
- The skin is opened using the previous surgical scar
- Soft tissues are carefully separated and the implant is exposed
- Screws and plates are removed with appropriate surgical instruments
- Bone and soft tissues are inspected and cleaned if needed
- The area is irrigated and skin layers are closed
Post-procedure
- Same-day or 1-day hospital stay (depending on the region)
- Wound care and suture inspection during the first week
- Gradual weight-bearing and motion program adjusted by limb
- Return to full activity usually within 4-8 weeks
- Follow-up X-rays to monitor healing
Risks
- Wound infection (possible with any surgical procedure)
- Risk of refracture during removal (especially in long bones)
- Injury to surrounding nerves or vessels (rare)
- Inability to remove a portion of the implant
- Anesthesia reactions, bleeding, and hematoma
FAQ
Does every implant need to be removed?
No. If the bone has fully healed and there are no complaints, many implants can be left in place permanently. The decision to remove is made individually based on pain, irritation, infection risk, and patient preference.
How long should one wait before implant removal?
Removal is usually considered at least 12 months after surgery and once bone union is confirmed by X-ray. This duration may be longer depending on the location and individual.
How long does the procedure take and is it painful?
Most implant removals take 30-90 minutes. No pain is felt during the procedure thanks to anesthesia; afterward, discomfort decreases within a few days with the prescribed pain relievers.
Will the bone break again after removal?
The risk is low, but there may be temporary weakness from screw holes, especially in long bones. It is necessary to avoid strenuous sports and impact for the period recommended by the physician.
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