why aren’t metal plates removed when the bones are fully healed?
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there is no need to remove them. They strengthen the bone and removing them would do more damage.
Depending on the severity of the original injury there’s sometimes concerns that the bones will never fully recover and it’s best to just leave the reinforcement in place indefinitely.
It’s also another surgery with another recovery and more risk – only worth doing if there’s good reason to remove the plate.
Every surgery has its risk: narcosis, infections – also costs. If metal plates do not interfere with the body, there is need to surgically remove them.
There are risks with any operation. Not only can the surgeon make mistakes but you can get dangerous infections through the incision which can cause even more issues. In any case you need time for the second surgery to heal including the bones where it attached to the plates. And in a lot of cases there is no issues leaving the hardware in place inside the body, it is certainly less of a problem then a surgery to remove it would be.
There are however cases where the hardware is causing issues and needs to be removed. Especially for smaller bones or fractures near joints it is not that uncommon to attach the plates to other pieces of bone then the ones that are fractured. This helps keep everything in place while it is healing. However it does limit the movement of the limbs so it needs to be removed, or at least part of it needs to be removed. There may still be hardware left inside the body after such a surgery, for example it is easier to just leave the screws in place and just remove the plate.
For what reason? You’re performing a costly invasive surgery on a person, cutting into them, risking infection, causing weeks of healing time for what benefit?
I haven’t seen it said, yet, but the bones and tissues heal *with* the hardware. Meaning that the new tissue grows into place and integrates into whatever microscopic pits and pock marks are in the hardware, or in some cases, completely around it. Pulling it out again may cause more harm then good and the tissues would have to be re-traumatized and coaxed to grow into the holes left from the removal of the hardware. Basically it’s a violation of “First, Do No Harm”
Because the bones are fully healed. You’d have to break them again to get the metal plates out. Not worth it, since we pick metals that can stay in the body forever without problems.
I lost a significant amount of muscle strength and it took about 3 months to “heal” after getting my metal plate and seven screws. It took another five years until it felt “normal” again. The point is, if they’re putting in a metal plate, they’re cutting through muscle and nerves and all sorts of stuff and it’s a bitch to heal.
Under certain circumstances they can be removed.
I’ve had a serious upper tibia fracture with 2 plates held by ten-ish screws, and asked for all that metal to be removed, because of constant discomfort. About 1½ year after the installation they were pulled out. Recovery was quick (I was home the same day; I had to use crutches, but I kept using them for less than a week), discomfort was immediately gone, I’m a happy camper, would do it again.
I had a simple fracture of my femur. Repaired by open reduction (go in through the side and put the bone ends together) and a long rod inserted from the hip end down through the marrow. A year later they pulled the rod out, a simple operation. I was 17. They told me if I’d been 70 they’d leave it in, but I needed the marrow, so they removed it.
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