What is hardware?
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 an orthopaedic foot and ankle surgeon will chose to remove this hardware.
What are the goals of hardware removal?
The goal of the procedure is to safely remove the hardware without causing damage to the surrounding soft tissues. These tissues are often 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 in some cases to safely remove the hardware.
What signs indicate removal may be needed?
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.
Hardware removal is often 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.
General Details of Procedure
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.
What happens after a hardware removal?
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.
For every surgical procedure there are risks. The most common risks following hardware removal are infection, nerve damage, re-fracture (breaking the bone again), and the risks of anesthesia. Discuss these possibilities with your surgeon before surgery and ways to help avoid them.
Frequently Asked Questions
Will my metal implant set off a metal detector?
It could, but it depends on how much hardware was used and how sensitive the metal detector is. Joint replacements will typically be detected. Plates, screws and similar implants may not be detected, depending on the machine.
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor.