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Do Plates and Screws Need to Be Removed After a Fracture?
In most cases, no. Once your bone is fully healed, the plates and screws have done their job, and modern hardware is designed to stay safely in place for the rest of your life.
Here is what I tell my patients. The metal we use is titanium or surgical stainless steel. It does not rust, it does not wear out, and your body does not treat it as a threat. After more than twenty years in orthopedic practice, I have seen far more people live comfortably with their hardware than ever need it taken out.
Removal is not part of routine care. It is a separate decision, made for a specific reason, and usually only after the bone is completely solid.
Why Is Most Orthopedic Hardware Left in Place for Life?
Because it is safe there, and taking it out carries its own risks. Plates, screws, rods, and pins are built to become quiet, permanent residents once healing is complete.
When you break a bone, hardware acts like an internal scaffold. It holds the pieces in the correct position so the bone can knit back together. Most fractures heal enough to stand on their own in about 8 to 12 weeks, followed by several more months of remodelling, which is the slow process where bone rebuilds its full strength.
After that, the screws are not actively doing anything. But they are not hurting anything either. This is especially true for hardware set deep in the body, like the femur (thigh bone) or pelvis, where thick muscle cushions the metal.
There is also a real cost to removing metal that is not causing problems. A second operation means anesthesia again, a fresh incision, and empty screw holes that briefly leave the bone weaker. For hardware that sits quietly, the safest choice is usually to leave it alone.
Is it safe to keep titanium plates and screws forever?
For the vast majority of patients, yes. Titanium and surgical stainless steel have been used for decades and are chosen because the body tolerates them well. They will not set off most airport security in a way that causes real trouble, and they do not need routine replacement the way a worn part might.
The same trusted metals are used in modern joint implants, including a total knee replacement and a hip replacement, which is one reason those parts are built to last for years. A small number of people are sensitive to certain metals, and a very small number develop irritation the body reacts to over time. Those are the exceptions I watch for, not the rule. If your hardware has been silent for years, it is almost certainly fine to leave it exactly where it is.
When Should Plates and Screws Be Removed?
When the hardware itself is causing a problem that will not settle on its own. That is the honest short answer. A few clear situations move a patient from “leave it in” to “let us talk about taking it out.”
Does hardware near the surface cause more trouble?
Yes, and this is the most common reason patients ask me about removal. Where soft tissue is thin, you can feel the metal. The tip of the elbow, the outer ankle, the wrist, and the shin are the usual spots.
In those areas, a plate can rub against a tendon or press on skin every time you kneel, lean, or wear a shoe. If it aches, catches, or feels like a hard bump you keep bumping, that irritation is worth reporting.
When do plates and screws need to be removed for infection or a loose implant?
An infection around metal is one of the strongest reasons to remove hardware. Bacteria can cling to a metal surface in a way that antibiotics alone struggle to clear, so taking the implant out is sometimes the cleanest path to healing, even months or years later.
Hardware that has loosened or broken is another. A loose screw can shift out of position, and a prominent piece can push against the skin from the inside and raise the infection risk. Other reasons include a true metal allergy and a nonunion, where a bone fails to fully knit and the fixation has to be revised.
Younger patients change the math too. In children, teenagers, and very active athletes, many surgeons favour removal once healing is complete, because growing bone and high-impact activity make long-term hardware more likely to cause issues.
What Does Hardware Removal Surgery Involve?
Usually less than the original operation did. In my experience, patients brace for something big and are relieved to hear how contained it often is.
Many removals are done as a day case, meaning you go home the same day. Depending on the site, your surgeon may use general or local anaesthetic. When the goal is a straightforward screw or plate near the surface, the incision is often small, closed with a few stitches and a dressing, and a plaster cast is usually not needed.
One important rule: timing. Hardware generally needs to stay in for at least a year, and only after the bone is fully solid. Going back in too early can disturb bone that has not finished healing, which defeats the purpose.
How long is recovery after plates and screws are removed?
Shorter than most people expect, though it depends on the location and how deep the metal was. The first 1 to 3 days are typically the most uncomfortable, and elevating the limb helps a great deal.
Stitches usually come out around 1 to 2 weeks. For a lower-limb removal, an average return to normal activity is about 3 to 4 weeks if there are no complications. Mild swelling can linger for 3 to 6 months, and a full recovery is often complete by the 12-month mark. Deeper or larger removals take longer.
What Are the Risks of Removing Plates and Screws?
Real, though usually low. This is the part of the conversation I never skip, because “the bone is healed” does not mean “the surgery is free.”
The main risks are infection, injury to small nerves near the incision (which can cause numbness that may be temporary or, less often, permanent), and refracture. That last one matters most in weight-bearing bones: when screws come out, the empty holes leave the bone briefly weaker, and it needs time to fill in before it takes full load.
Sometimes only part of the hardware can be removed, because a screw has become embedded in bone or breaks during the procedure. In that case the surgeon trims what remains flush with the bone.
The evidence on outcomes is encouraging when there is a clear reason to operate. In a study of 332 patients who had hardware removed, the overall complication rate was about 10 percent. Yet among those who had it taken out because of pain, 96 percent reported less pain afterward, and 72 percent noted better function. Notably, 96 percent of patients said they would choose removal again. The lesson I draw is simple: when the metal is truly the problem, removal tends to help; when the pain is vague and generalised, the result is far less predictable.
How I Help Patients in Franklin and Middle Tennessee Decide
I start by answering the real question: is the hardware the problem, or is something else going on? At the Bone and Joint Institute of Tennessee in Franklin, I see patients from Nashville, Columbia, and across Middle Tennessee who are living with plates and screws and wondering whether they should come out.
Here is my honest guidance. If your hardware is quiet, leave it be. If it consistently hurts, catches on movement, sits right under the skin, or shows any sign of infection, let us look closely, confirm the bone is fully healed, and weigh removal against the risks together. That is a decision worth making with an experienced orthopedic surgeon, not from a search bar. You can find more patient guides like this on the Dr. Calendine blog.
If plates or screws are bothering you, you do not have to guess. Schedule a consultation with Dr. Cory Calendine to review your imaging and talk through your options. You can also reach the office at (615) 791-2630, Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067.
This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider before making decisions about your care. Individual results vary based on your personal health circumstances.
References
- Reith G, Schmitz-Greven V, Hensel KO, Schneider MM, Tinschmann T, Bouillon B, Probst C. Metal implant removal: benefits and drawbacks, a patient survey. BMC Surgery. 2015;15:96.
- Hanson B, van der Werken C, Stengel D. Surgeons’ beliefs and perceptions about removal of orthopaedic implants. BMC Musculoskeletal Disorders. 2008;9:73.
- American Academy of Orthopaedic Surgeons. OrthoInfo: Internal Fixation for Fractures. Rosemont, IL: AAOS.
- Royal Orthopaedic Hospital NHS Foundation Trust. Removal of Internal Fixation: Patient Information. Birmingham, UK.
