Many foot and ankle procedures require insertion of metal plates, screws, rods, or similar implants for stabilization of the bones while they heal. There are a number of reasons why your foot and ankle orthopaedic surgeon may chose to remove this hardware. Hardware can be removed if it is painful or associated with an infection, or if your bone didn’t heal as hoped, which may require new hardware to be placed.
The goal of the procedure is to safely remove the hardware without causing damage to the surrounding soft tissues. These tissues often are scarred from previous surgery. Nerves and blood vessels and other soft tissue structures in this area may be at greater risk than at the time of the original surgery. A larger incision than the original surgical incision may be required to safely remove the hardware.
There are several reasons why your surgeon may offer hardware removal. Pain due to hardware is the most common reason. Other reasons include infection, nerve damage due to scarring, incomplete healing of the bone (called a non-union), or an allergy to the implant. If you have a metal allergy, it is important to let your surgeon know before surgery, as special implants may be used to minimize complications.
Your surgeon will usually use the previous incisions to find and remove the hardware. In some cases these incisions are made longer or additional incisions are made to safely perform the operation.
Hardware removal often is combined with other procedures. If there is an infection, your surgeon will remove the infection with a procedure called debridement. Nerves can be injured during the healing process due to scarring. If this occurs, the nerve can be freed from the scarring with a procedure called a nerve decompression.
When bone has not healed, further stabilization or correction may be performed. Different implants may be used and sometimes bone grafting is performed to try to get the bone to heal. An allergy to metal is uncommon, but when it occurs, the hardware is removed and sometimes a different type of metal is used. In general, an attempt is made to keep the hardware in place after surgery so the bone can heal. It can be removed later if necessary.
You should always ask your surgeon before an operation about your restrictions afterward. There are times when you may be allowed to put some weight on the limb during your recovery, but it is important to ask about this first.