Patient education: Pin, plate, or screw removal (The Basics)

What is pin, plate, or screw removal? — Metal pieces like pins, plates, or screws are used during certain types of surgery to hold a bone in place. For example, if you fracture a bone, your doctor might use metal pins to hold the bone together as it heals.

In many cases, the pins, plates, or screws do not need to be removed, and stay in place for the rest of a person's life. But other times, they need to be removed.

Reasons that they might need to be removed include:

●The pins, plates, or screws are causing you pain or discomfort.

●You have an infection in your bone, and treatment with medicines has not worked.

●You have an allergic reaction to the metal.

●The pins, plates, or screws are causing nerve damage.

●The fractured bone did not heal properly – In this case, the metal pieces are removed so the doctor can try to "set" the bone again.

●The bone has healed, and the pins, plates, or screws are no longer needed – This is common in children. Once a child's fracture has healed, any metal pieces that were used are removed. This is so their bones can continue to grow and develop normally.

Surgery to remove pins, plates, or screws can be done in 2 ways:

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make a few small cuts in the skin. They insert tools through the cuts. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the tools to remove the metal pieces.

●Open surgery – During open surgery, the doctor makes 1 large cut near the metal pieces. It might take you longer to return to normal activities if you had an open surgery.

You might be able to return to normal activities sooner if you had minimally invasive surgery than if you had an open surgery.

How do I prepare for pin, plate, or screw removal? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Imaging tests – These create pictures of the inside of your body. They can help your doctor see the pins, plates, or screws, and how well your bone has healed. Imaging tests can also show if there are any signs of infection.

●Lab tests

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during pin, plate, or screw removal? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will make 1 or more cuts (incisions) in your skin near the pin, plate, or screw. Then, they will use special tools to remove the metal from your bone.

●If you have infected tissue near the pin, plate, or screw, your doctor will remove it. If your doctor was planning to replace any pins, screws, or plates with new ones, this will have to wait until the infection is gone.

●The doctor will close your incisions and cover them with clean bandages.

What happens after pin, plate, or screw removal? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●If you had general anesthesia, you might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

If your doctor thinks that you have an infection caused by your pins, plates, or screws, they might take a sample from the metal for lab testing. This will help your doctor figure out exactly what kind of infection you have, and how to treat it.

What are the risks of pin, plate, or screw removal? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding

●Damage to your nerves or other body tissues

What else should I know? — Depending on why your pins, plates, or screws were removed, you might need other treatments:

●If you have an infection, you might get antibiotics to treat it. You might also need to get weekly blood tests while you are taking antibiotics. This will help your doctor know if they are working. If you need more treatment to heal the bone, it will most likely have to wait until the infection is gone.

●If your bone did not heal properly, you might need a procedure called a "bone graft" or other treatments to heal the bone. You might have a cast or other device to keep the bones stable.

●You might need to limit your physical activity while you heal. Your doctor or nurse will tell you if this is the case.

More on this topic

Patient education: Surgery to fix a broken bone (The Basics)
Patient education: Fractures (The Basics)