What is Foot and Ankle Hardware Removal?
Foot and ankle hardware removal is a surgical procedure to remove orthopedic implants such as screws, plates, rods, or wires that were previously used to stabilize fractures or correct deformities in the foot and ankle. These implants are typically placed during foot and ankle surgeries for conditions like fractures, arthritis, bunion corrections, or tendon repairs.
Indications for Foot and Ankle Hardware Removal
Hardware is typically designed to remain in place permanently, but removal may be necessary due to:
- Pain or Discomfort – Some people experience irritation from the hardware, especially if it is prominent under the skin.
- Infection – If an implant becomes infected, removal may be necessary to prevent further complications.
- Allergic Reaction: Rarely, some individuals may have an allergic reaction to metal implants.
- Impingement or Limited Mobility – Hardware can interfere with tendons, joints, or soft tissues, causing restricted movement.
- Nonunion or Malunion – If a fracture fails to heal correctly, revision surgery may involve removing old hardware.
- Breakage or Loosening – Screws, plates, or rods can become damaged or shift over time.
Procedure for Foot and Ankle Hardware Removal
In general, the procedure for foot and ankle hardware removal may include the following steps:
- Preoperative imaging tests, such as X-rays or CT scans, are performed to help determine the hardware’s position and condition.
- Anesthesia is administered - local, regional, or general anesthesia, depending on the complexity of the procedure and patient preference.
- The surgeon makes an incision, often along the original surgical site, to access the hardware.
- Soft tissues (skin, muscle, and fascia) are carefully moved aside to expose the hardware while minimizing damage to surrounding structures.
- Screws, plates, rods, or wires are removed using specialized tools.
- If bone or scar tissue has grown around the hardware, the surgeon may need to drill or carefully detach it.
- If the hardware is broken or difficult to extract, additional techniques, such as fluoroscopy (real-time X-ray), may be used for guidance.
- The treatment area is examined to ensure there is no residual infection, damage, or instability.
- The incision is closed with sutures or staples, and a dressing or bandage is applied to protect the wound.
Postoperative Care and Recovery
Postoperative care and recovery following foot and ankle hardware removal is focused on pain management, wound care, and gradual return to activity. Pain and swelling are common and can be managed with prescribed or over-the-counter pain relievers, ice application, and elevating the foot to reduce inflammation. Patients may need to limit weight-bearing initially, depending on the extent of bone healing, and may use crutches, a walker, or a protective boot for support. If the bone is fully healed, walking can often resume immediately. Proper wound care is essential to prevent infection, and sutures or staples are typically removed within 10–14 days. Some individuals may benefit from physical therapy to restore strength, mobility, and balance. Swelling and discomfort may persist for several weeks, but most patients recover within a few weeks to months, gradually returning to normal activities as healing progresses.
Risks and Complications
Foot and ankle hardware removal is generally a safe procedure, but like any surgery, it carries potential risks and complications, such as:
- Infection
- Nerve injury
- Bone weakening or fractures
- Persistent pain or scar tissue formation
- Delayed healing or joint stiffness
- Incomplete removal or retained hardware
