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  1. #1
    Join Date
    May. 21, 2009
    Location
    Apex, NC
    Posts
    677

    Default "Hardware removal" of previous fracture?

    four years ago, I had a tri-malleolar fracture. I have a nice sized plate with screws on one side and pin on the other side. I have been contemplating having them removed. For anyone who has had this done, does it make a big difference in how your leg/ankle works, flexibility in the joint? I don't want to do this if it won't make a difference. I can live with the scar tissue over the screws, it only rubs once in a while. Just wondering what your experiences are or were? I have decent ROM in my foot, but getting this side of my body correct takes a bit more effort than I would like. Is it just something I am resigned to live with? Thanks for any input you can give.



  2. #2
    Join Date
    Mar. 22, 2006
    Location
    Utah
    Posts
    173

    Default

    Sounds very similar to my fracture! I too had a tri-malleolar 2 years ago. Plate on my fibula with 11 screws, and 2 other long screws to hold my medial malleolus back in place. One year after my break and initial surgery, I had all of the hardware removed. It has been one year since my hardware removal surgery. I am SO glad I had it removed! I have improved range or motion and less irritation to both areas. I am much more comfortable riding and can easily get my heels down now.



  3. #3
    Join Date
    Aug. 3, 2004
    Location
    San Francisco
    Posts
    3,823

    Default

    I had the same thing.

    I have kept the hardware. I feel it occasionally.

    I did have to have one screw removed because the skin just wouldn't heal over it and I got one of those nasty resistant infections.

    Healing always takes too long for me. I am done having elective surgery so I am keeping it in.

    I figure it makes the ankle stronger anyway!
    A man must love a thing very much if he not only practices it without any hope of fame or money, but even practices it without any hope of doing it well.--G. K. Chesterton



  4. #4
    Join Date
    Jan. 21, 2003
    Location
    Charles Town, WV
    Posts
    6,637

    Default

    Not the malleolus, but the ulna. Every time I put my arm down on something I went through the roof! I asked if they could take out the plate (long) and 8 screws. They said, "Well, let's see. First we'll take an x-ray and see what's going on." They took the x-ray and scheduled me immediately for surgery to take out the plate and screws. The ulna had decided to give up the ghost and let the plate do the work and had started to seriously demineralize so out it came - quickly! Man am I glad I had it out. The plate on the radius is buried so deep they said they would essentially never take that one out. Wasn't really a ROM question, but I'm sure glad it's out.
    Tranquility Farm - Proud breeder of Born in the USA Sport Horses, and Cob-sized Warmbloods
    Now apparently completely invisible!



  5. #5
    Join Date
    Jan. 4, 2007
    Location
    TX
    Posts
    40,850

    Default

    My ulna also has a plate and 7 screws, but the surgeon put it on the inside and said it should stay there without problems, because "at my age" he didn't want to operate again.
    He said that on principle, he doesn't leave hardware in patients, but sometimes it is the best.

    Maybe you could get a second opinion?



  6. #6
    Join Date
    Apr. 13, 2006
    Posts
    921

    Default Hardware removal does not.....

    per se correlate with increased function
    UNLESS
    there is pain involved with the hardward.

    If I understand your post correctly, it is not the ankle that is the big problem, but the lack of function of the whole body that resulted from the ankle injury.

    Which leads me to ask what is your off horse conditioning program to keep your ankle and affected side in tune?

    REgards,
    medical Mike
    equestrian medical researcher
    www.equicision.com



  7. #7
    Join Date
    May. 21, 2009
    Location
    Apex, NC
    Posts
    677

    Default

    I will be the first to admit I don't do the exercises every day, but I do(minimum) exercises that keep my range of motion going. They are the ones I was taught in PT. I should probably incorporate some more stretching exercises for me altogether. I def. need a better workout program, but I was just curious too if having hardware removed any difference in the mobility of the foot/ankle joint itself, or if it is something that can be achieved through a better program.



  8. #8
    Join Date
    Apr. 13, 2006
    Posts
    921

    Default Yes, Yes and possibly....

    You should be doing some type of off horse strengthening on a regular basis.

    It is not difficult to construct one.......

    Stretching is only part of the answer...STRENGTHENING is more important.

    You are better served developing a whole body program.

    REgards,
    Medical Mike
    equestrian medical researcher
    www.equicison.com
    Last edited by medical mike; Jul. 21, 2010 at 06:51 PM. Reason: posted too early, not finished writing.



  9. #9
    Join Date
    May. 12, 2010
    Location
    Westchester County, NY
    Posts
    955

    Default

    I had the hardware removed from my broken (9 pieces) collarbone after seven months. After seven more months the collarbone broke again. All the hardware back in, plate, screws, and bone grafts. That was 12 years ago, all the hardware is permenant. Needless to say, my shoulder is not a weight bareing limb, so I am not sure this is a good comparison.



  10. #10
    Join Date
    Apr. 25, 2004
    Location
    Lexington, KY
    Posts
    1,519

    Default

    Has anyone had "dissolvable" screws removed? Or had problems with them?

    I had 3 that were used in my surgery in 2005, 1 dissolved, and 2 are still hanging out. I occasionally get pain from them but they never really covered up like they should have so I do feel them if I happen to brush the area. I really would like them out, because in my opinion they are malfunctioning...they were supposed to cover themselves & dissolve!

    I figured I would ask the question here since everyone is responding about hardware....or would this be considered "software" since it's not metal? :-)
    "The horse you get off f is not the same horse you got on. It is your job as a rider to ensure that as often as possible, the change is for the better" - unknown author



  11. #11
    Join Date
    Apr. 13, 2006
    Posts
    921

    Default www.pubmed.org

    I did a quick search and if you are interested in what the research says, you can find answers to your questions there.

    If you are interested in the PAPERS, you would need to access the website through a medical or possibly a college library.

    Regards,
    medical Mike
    equestrian medical researcher
    www.equicision.com



  12. #12
    Join Date
    Jun. 29, 2008
    Location
    San Diego
    Posts
    2,205

    Default

    I have a plate and 7 screws from a mid shaft ulnar fracture back in 2003 and ever since have toyed with the idea of removing it since it is right under the skin and hurts like a bit** when I bump it. But, I'm terribly afraid of needles and another surgery (and the cost) so I'm holding back.
    Proudly Owned By Sierra, 2003 APHA Mare
    In Loving Memory of Tally, April 15, 1983 - June 2, 2010



  13. #13
    Join Date
    Dec. 11, 2004
    Location
    Maryland
    Posts
    1,704

    Default

    Not the same injury as you Mr. GMan, but I recently had hardware removed from my elbow after some serious reconstruction (see this thread for some more info), and was very glad I did it!

    Have you asked your surgeon what, if any, additional mobility might you gain by removing the hardware? My surgeon was quick to tell me that it wouldn't give me more ROM (I had great ROM after the first surgery, so that really wasn't why I was going to do it). I had a plate that stuck out something fierce, and then it started catching on subcutaneous tissue whenever I tried to move it (ouch!! ).

    My hardware removal went very smoothly. The surgeon took everything he could get his hands on. The only things left are a couple of pins that are embedded in so deep that they are basically part of my bone now. It was outpatient and they ended up doing it under twilight anesthesia and a nerve block (instead of general). The nerve block was great- lasted around 12 hrs with a gradual wear off (I've heard that's not always the case though). And, after a few days I was allowed to start moving it again. The hardest part was waiting 6 weeks to ride again. Pain was not nearly as bad as the first surgery, and while it did take a bit of motivation on my part to get the ROM back (it's amazing how quickly that tightens up), I really had no problems getting it back without going to PT.



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