# Anyone have hardware removed after bone fracture healed?



## BarryG (Jul 5, 2004)

Back in July I fractured my hip in a bad crash and had a pin, plate and screws inserted in my femur. The hardware has caused me nothing but grief for the past two months and thankfully the surgeon will be removing the hardware next week.

I was wondering if anyone knew how long it generally takes for the holes in the bone to fill in (i.e., re-calcify). One month? More? 

Thanks,
Barry


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## Spoke Wrench (Aug 20, 2001)

What kind of grief has the hardware caused you?

I've got 4 titanium screws and a wrap of what must be the world's most expensive baleing wire on my collar bone. It's been 7 or 8 years with no issues for me but I've heard of other people having problems and I'd be interesting in knowing what I might expect.


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## BarryG (Jul 5, 2004)

Spoke Wrench said:


> What kind of grief has the hardware caused you?


The first ten weeks of the recovery after surgery went fine. Then I hit a wall - I experienced constant soreness/inflammation with tenderness over the hardware. If I did the usual exercising that I had been doing up until then, I would limp badly and hurt for a week afterwards. I had to stop all exercising completely. We tried one round of anti-inflammatory injections that had zero effect. The surgeon, who is somewhat sports-oriented, felt the hardware had to come out for me to continue a good recovery. I'm VERY happy that he's willing to do it now.


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## alienator (Jun 11, 2004)

BarryG said:


> Back in July I fractured my hip in a bad crash and had a pin, plate and screws inserted in my femur. The hardware has caused me nothing but grief for the past two months and thankfully the surgeon will be removing the hardware next week.
> 
> I was wondering if anyone knew how long it generally takes for the holes in the bone to fill in (i.e., re-calcify). One month? More?
> 
> ...


The holes left by the hardware can generally be treated like fractures....depending on how big the holes are. Still, bone pain won't be the issue that you'll have to contend w/ the most. The toughest thing you'll have to face is the aftermath of having the muscles around that area cut up again.

Good luck.


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## SHVentus (Mar 15, 2004)

BarryG said:


> Back in July I fractured my hip in a bad crash and had a pin, plate and screws inserted in my femur. The hardware has caused me nothing but grief for the past two months and thankfully the surgeon will be removing the hardware next week.
> 
> I was wondering if anyone knew how long it generally takes for the holes in the bone to fill in (i.e., re-calcify). One month? More?
> 
> ...


Once the hardware has served it's purpose in stabilizing the fracture (if it/they can be removed), once the fracture has healed, it's best to remove all implants, as they increase the risk for bone cancer due to their micro movement in the bone over years of time by stimulating the osteoblasts, osteoclasts, etc. 

Everyone is different in their rate of healing, and therefore in the re-modeling of the bone & the filling in of the holes left by the screws & pins, but generally would be expected to be filled in in 2-3 months. Best to ask your orthopod for your particular circumstances. 
X-rays will confirm them being filled in. Best of luck.


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## BarryG (Jul 5, 2004)

Thanks guys. Doc already said he won't be x-raying to check on the holes - he said I'll be on crutches again for a month or so, can ride the trainer after one month, and can ride the road after 3 months.

I just hope the effects from the muscle trauma (they cut the vastus lateralis) aren't too bad, but that will sort itself out in the near term.


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## Alpinist (Jul 27, 2005)

*Fun Fun*

I highsided in a race (motorcycle road racing) in the last race of the season. Anyway, I shortened my left arm 1/2". Actually crushed the cartiledge in my wrist, mushroomed the head of that bone and had multiple splits running down towards my elbow. I had a external fixator (4 long pins in the bones, clamps and a rod between) on that wrist for 9 weeks.

When it was time to get the pins out, the Dr got out the cordless drill. He tightened the drill, on each pin, like you would a drill bit and told me to hang on. I was sweating pretty good by the time he broke the 4th pin loose and ran it out. The tip of the pin has is self tapping.  I guess the wrist was still so uncomfortable that I didn't seem to notice the holes left by the pins. Geeze, it was 12 months before I had 99% range of motion again and the pain was completely gone. 

Good luck and I hope things work out for you.


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## Spoke Wrench (Aug 20, 2001)

SHVentus said:


> once the fracture has healed, it's best to remove all implants, as they increase the risk for bone cancer due to their micro movement in the bone over years of time by stimulating the osteoblasts, osteoclasts, etc.


The "C" word. Now I'm sorry that I asked.


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## c_davis_jr (Mar 28, 2004)

My orthopedic surgeon says it takes about 6 weeks for the holes to heal up - just had two screws removed from my knee six weeks ago. He told me riding is fine (just don't crash) and you can run again in about six weeks. I've been taking calcium pills as well. Not sure if that helps, but if makes me feel like I am contributing to the healing process...

Good luck.


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## alienator (Jun 11, 2004)

c_davis_jr said:


> My orthopedic surgeon says it takes about 6 weeks for the holes to heal up - just had two screws removed from my knee six weeks ago. He told me riding is fine (just don't crash) and you can run again in about six weeks. I've been taking calcium pills as well. Not sure if that helps, but if makes me feel like I am contributing to the healing process...
> 
> Good luck.


Calcium good. During fracture healings I eat Tums like a madman. Another consideration is this: if you want to be back as quickly as possible, ask your doc if he'd prescribe Fosamax for you. I took Fosamax for quite a few months after a motorcycle racing skeletal disruption. It works, although it's muy expensive.


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## rogger (Aug 19, 2005)

c_davis_jr said:


> My orthopedic surgeon says it takes about 6 weeks for the holes to heal up - just had two screws removed from my knee six weeks ago. He told me riding is fine (just don't crash) and you can run again in about six weeks. I've been taking calcium pills as well. Not sure if that helps, but if makes me feel like I am contributing to the healing process...
> 
> Good luck.


I got me some calcium-magnesium-zinc pills when I cracked my ribs, the zinc does nothing for your bones but magnesium is important for bonegrowth. If it really doesn't make any difference physiologically it will always make a difference feeling that you are doing something to get better so any which way, it works.


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## yellowspox (Apr 3, 2003)

Spoke Wrench said:


> What kind of grief has the hardware caused you?
> 
> I've got 4 titanium screws and a wrap of what must be the world's most expensive baleing wire on my collar bone. It's been 7 or 8 years with no issues for me but I've heard of other people having problems and I'd be interesting in knowing what I might expect.


Yup, I know the feeling. For what I paid and went through, I'd just as soon keep the screws and wire. Besides, it's kind of neat to watch the skin move over the top of the screws when you raise your arm to shave in the morning!! LOL It's also a great reminder to keep the speed at a reasonable level on the downhills!


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## XCGEEK (Jan 23, 2002)

SHVentus said:


> Once the hardware has served it's purpose in stabilizing the fracture (if it/they can be removed), once the fracture has healed, it's best to remove all implants, as they increase the risk for bone cancer due to their micro movement in the bone over years of time by stimulating the osteoblasts, osteoclasts, etc.


This is an interesting statement, please post some peer reviewed studies that prove such a relation, or stop spreading old wives tales. Thank you.

J


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## SHVentus (Mar 15, 2004)

XCGEEK said:


> This is an interesting statement, please post some peer reviewed studies that prove such a relation, or stop spreading old wives tales. Thank you.
> 
> J


I've seen it first hand many times, over many years in practice, and have read numerous journal & textbook articles of the same. Sunburst appearance of the bone at the site of implants. Believe what you will.


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## XCGEEK (Jan 23, 2002)

SHVentus said:


> I've seen it first hand many times, over many years in practice, and have read numerous journal & textbook articles of the same. Sunburst appearance of the bone at the site of implants. Believe what you will.


What is your profession? If there truely are articles proving this I would like to see them, in all honesty. I can not find any on Pubmed, nor have I been able to find a orthopod or eurologist who shares your experiance. Thank you.

J


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## Jamieshankland (Jan 8, 2005)

I know several people who had pins in them. It all comes down to how well your body put up with it when it was in and how strong your bones are.

A friend of mine straight legged in a crash and broke the head off his tibia. He had many pins and a plate from when they put it back together, his body did'nt reject the titanium bolts so they stayed in.

My brother had his shoulder pinned backtogether and he started to re-calcifie so fast it was pushing the pin out and had to get it put back in. It looked like a huge pimple sticking out haha. When they knew his shoulder worked again, the pin came out and became a fixture on the trophie rack! The funny part was in how he was told to relax and not do anything crazy physical while it was in, when they removed the thing it had an obvious bend in it.


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## SHVentus (Mar 15, 2004)

XCGEEK said:


> What is your profession? If there truely are articles proving this I would like to see them, in all honesty. I can not find any on Pubmed, nor have I been able to find a orthopod or eurologist who shares your experiance. Thank you.
> 
> J


Here's just one reference (there are numerous, & quite easy to find):

Canine Orthopedics (ISBN 0-8121-1086-2), by Bill Whittick, 2nd Ed.; chpt. 25, Neplasms of bone pp 857-895.
"................and osteosarcomas associated with metal implants have also been reported in dogs." "In the 11 reported cases and the 6 additional cases from the Animal Medical Center, the age distribution of the 17 dogs with metal-implant-induced osteosarcoma ranges from 3 to 18 (mean 7.4) years."


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## alienator (Jun 11, 2004)

SHVentus said:


> Here's just one reference (there are numerous, & quite easy to find):
> 
> Canine Orthopedics (ISBN 0-8121-1086-2), by Bill Whittick, 2nd Ed.; chpt. 25, Neplasms of bone pp 857-895.
> "................and osteosarcomas associated with metal implants have also been reported in dogs." "In the 11 reported cases and the 6 additional cases from the Animal Medical Center, the age distribution of the 17 dogs with metal-implant-induced osteosarcoma ranges from 3 to 18 (mean 7.4) years."


How about ref. an article on humans. I've had 4 different surgeries wherein hardwared was installed, with three different orthopods, and NEVER has this been discussed as a potential risk nor has it been written in anything as a potential risk. Further, there are clearly cases when the hardware needs to stay in, whether it be due to the type of injury or the medical history of the patient. Frankly, I think it's pretty irresponsible to make the statement that you've made, especially since you have zero knowledge of the patient history, nor any knowledge of the surgeons reasons for his medical decisions.


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## litespeedchick (Sep 9, 2003)

Yeah, I'm sorry you asked too!

I've got 2 pins and a plate w/ 7 screws - Ti, of course, and yes, they were a bit more expensive than the Ti in the bike that did it to me, pound for pound. That was in '99 and I don't set off metal detectors in the airport, and they don't bother me al all, although I have to be careful shaving my legs if I don't want to get an up close and personal look at the screw heads. My orthopod said it would be best if I could keep them, and I've been happy to...it's good party trick to let people feel your screws. 

No mention of cancer. Even if it does increase the risk of bone cancer, isn't the risk of bone cancer pretty darn small? I'm going to operate on the theory that an infinitesimal increase in an already tiny risk = a negligible risk. 

BTW, a friend tells the story of a fellow cheerleader in highschool who broke her leg, had screws in her ankle, and one day a year or so later was sitting in class when she felt a stinging sensation. Reached down to find blood and the screw backing out of her leg. Ewh.


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## alienator (Jun 11, 2004)

litespeedchick said:


> That was in '99 and I don't set off metal detectors in the airport, and they don't bother me al all, although I have to be careful shaving my legs if I don't want to get an up close and personal look at the screw heads.


Now the trick to setting off airport metal detectors is having an internal bone growth stimulator. I got one in surgery #4 to repair a mangled lower leg (from superbike racing). What it was....uhm....was a signal generator that applied a designed current( via two electical leads plugged into the bone )to a fracture site. I discovered one day when dropping wifey off at the airport (NOTE: this was in 2002, in a very post 9/11 sensitive airport). I noticed that if I walked to within about 15-20 feet of the metal detectors, I could set 'em off. So that's what I did, periodically over the course of an hour or so....wander toward the detectors, set 'em off, then wander away. Oy, I made myself giggle pretty good. Electrical fields and induced magnetic fields are wonderful things.


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## Chase15.5 (Feb 17, 2005)

yellowspox said:


> Yup, I know the feeling. For what I paid and went through, I'd just as soon keep the screws and wire. Besides, it's kind of neat to watch the skin move over the top of the screws when you raise your arm to shave in the morning!! LOL It's also a great reminder to keep the speed at a reasonable level on the downhills!


I had my screws removed because the tendon was rolling over the screws and the tendon started to snag on the screws. It was quite painful when it would snag then snap forward. This was in my knee so you can imagine the feeling each time my knee flexed while riding...ouch! Since the removal - no pain.


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## fixintogo (Nov 14, 2005)

alienator said:


> Further, there are clearly cases when the hardware needs to stay in, whether it be due to the type of injury or the medical history of the patient. Frankly, I think it's pretty irresponsible to make the statement that you've made, especially since you have zero knowledge of the patient history, nor any knowledge of the surgeons reasons for his medical decisions.



Alienator, it seems that if there are sound medical reasons for leaving the implants in, no one is advocating that they be removed; that issue is entirely between the patient and his physician. SHV is simply stating that there may be an increased risk, as a link has been found in canines. As the proud owner of a titanium implant, I think it's worth knowing about and I plan to ask my doctor his opinion. Taking SHV to task as you have, calling him "irresponsible" simply for disseminating information makes you sound combative and defensive. I can't imagine why you find it appropriate to berate him.


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## SHVentus (Mar 15, 2004)

fixintogo said:


> Alienator, it seems that if there are sound medical reasons for leaving the implants in, no one is advocating that they be removed; that issue is entirely between the patient and his physician. SHV is simply stating that there may be an increased risk, as a link has been found in canines. As the proud owner of a titanium implant, I think it's worth knowing about and I plan to ask my doctor his opinion. Taking SHV to task as you have, calling him "irresponsible" simply for disseminating information makes you sound combative and defensive. I can't imagine why you find it appropriate to berate him.


Thank you fixintogo,

I find it interesting to see how many people give medical advice with no degree or expertise (worse, how many people listen to & follow it), other than their own (single) experience, yet as you mention, poo poo someone with 30 years experience as a Dr.; (ie, do this, take this, never/always do....................., etc.) There are exceptions to every rule. Calcium may be good in some cases, not in others."Fosamax" may be good for 1 individual & not for another. Etc., etc., etc. To suggest someone else to do, or take A,B,C, etc. not knowing the case, not being a Dr., etc --- that's irresponsible. 

Any implant is a foreign body, a foreign substance, not normally found in the human/animal body, and as originally stated, if it can be removed, once it has served it's purpose, you would be better off without it. Removed, it won't be there to potentially cause any harm, anything from a benign sensatiojn of cold with temp. drop, irritation, annoyance, inflammation, problems from micro movement or reaction to breakdown corrosion elements from the implant, etc., etc., all the way to yes, an increased risk for cancer. Hey, if you like having a foriegn substance in your body, if you like feeling "cool" knowing it's there, bragging about your "war wounds", showing it off, about setting off detectors, feeling the screws/pins/and plates under your skin - so be it. I just feel an informed decission is better. It's your body & your choice.

If anyone goes back & re-reads my original post, I suggested that:

1. Removal only after the implants had served their purpose - if possible (sometimes it isn't).
2. Everyone is an individual, & therefore different - every case is different - and should be evaluated as such.
3. Best for each person to check with their orthopod regarding their case. Make an informed decission for yourself.


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## BarryG (Jul 5, 2004)

Friday's the day - the hardware is coming out with an overnight stay in the hospital afterward. In my case it was a no-brainer: for the past two months, each day that goes by has meant more and more discomfort and a more pronounced limp. I am VERY aware of its presence as a now-unwanted foreign object. Taking it out means I can once again get back on the road to recovery.


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## amygdala (Dec 28, 2005)

BarryG said:


> Back in July I fractured my hip in a bad crash and had a pin, plate and screws inserted in my femur. The hardware has caused me nothing but grief for the past two months and thankfully the surgeon will be removing the hardware next week.
> 
> I was wondering if anyone knew how long it generally takes for the holes in the bone to fill in (i.e., re-calcify). One month? More?
> 
> ...



I had hardware removed from my ankle after a bad fall climbing and the removal of the hardware was a non issue. There was no additional pain as a result of the hardware, and within a couple days i was doing everything I did before the removal.


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