What is Orthopedic Hardware Removal

Hardware removal is a procedure to remove from the body any medical parts—such as pins, screws, rods, wires, or plates—that were used to repair a broken bone. This procedure may be done to:

• Remove medical parts that are normally removed after a broken bone has healed.
• Remove medical parts that are causing problems, such as infection or pain.
• Remove medical parts that are not working.
• Replace medical parts with newer, better materials.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines. This includes any use of steroids, either by mouth or in cream form.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Long-term pain.
• The bone breaking again (refracture).
• Damage to other structures or organs, such as blood vessels or nerves.
• Failure to completely remove the medical parts.
• Blood clots.

What happens before the procedure?

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure, you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• Eight hours before the procedure: Stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
• Six hours before the procedure: Stop eating light meals or foods, such as toast or cereal.
• Six hours before the procedure: Stop drinking milk or drinks that contain milk.
• Two hours before the procedure: Stop drinking clear liquids.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision and bone healing. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.
• You may have X-rays taken.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• The surgeon will make an incision over the area where the medical parts are located.
• The medical parts will be removed.
• The incision will be closed with stitches (sutures), staples, or surgical glue.
• A bandage (dressing) will be placed over the incision site to keep it clean and dry.
• A splint, cast, or removable walking boot may be applied until the area heals.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be given medicine for pain as needed.
• Do not drive for 24 hours if you were given a sedative during the procedure.
• Ask your health care provider when it is safe to drive if you have a splint, cast, or removable walking boot on the injured area.

Summary

• Hardware removal is a procedure to remove from the body any medical parts—such as pins, screws, rods, wires, or plates—that were used to repair a broken bone.
• Medical parts may need to be removed because they are causing problems or not working, or they may not be needed any longer.
• Be sure to follow your health care provider’s instructions for before and after the procedure.

Orthopedic Hardware Removal, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness or pain.
• Some swelling in the area where the hardware was removed.
• A small amount of blood or clear fluid coming from your incision.

Follow these instructions at home:

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Tell your health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
• Keep the cast clean and dry.

If you have a splint or boot:

• Wear the splint or boot as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint or boot if your fingers or toes tingle, become numb, or turn cold and blue.
• Keep the splint or boot clean and dry.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.
• If your cast, splint, or boot is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness.
  • More swelling or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area:
  • If you have a removable splint or boot, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your fingers or toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• Ask your health care provider when it is safe to drive if you have a cast, splint, or boot on the affected limb.

Activity

• Ask your health care provider what activities are safe for you during recovery, and ask what activities you need to avoid.
• Do not use the injured limb to support your body weight until your health care provider says that you can.
• Do not play contact sports until your health care provider approves.
• Do exercises as told by your health care provider.
• Avoid sitting for a long time without moving. Get up and move around at least every few hours. This will help prevent blood clots.

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing after surgery. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have lasting pain.
• You have redness around your incision.
• You have more swelling or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You are unable to do exercises or physical activity as told by your health care provider.

Get help right away if:

• You have difficulty breathing.
• You have chest pain.
• You have severe pain.
• You have a fever or chills.
• You have numbness for more than 24 hours in the area where the hardware was removed.

Summary

• After the procedure, it is common to have some pain and swelling in the area where the hardware was removed.
• Follow instructions from your health care provider about how to take care of your incision.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.