Fibula plate removal

Hey folks,

I am wondering if anyone has any experience getting a plate removed after a fibula fracture?

I had this plate installed after spiral fracturing my fibula 8 months ago. Initially, I was under the impression that the hardware would stay unless it bothered me, and the doctor said that in most cases it wasn't a problem to leave in. In addition, I broke my other leg's tibia two years ago, and I never had issues with the hardware there. These two things led me to believe that it would stay.

Anyways, now I am feeling strong after a lot of rehab and PT. I can squat and deadlift close to normal levels, do more single leg calf raises than I could before the injury, and my balance has returned. I have been doing pretty significant single leg jump routines. Lastly, I am beginning to run again, but haven't progressed enough here to say I'm back to normal.  The issues come about after significant time spent on my feet. Anything past a "medium" hike will leave me close to limping home. Even things like walking to the grocery store, shopping for a bit, and returning will be somewhat challenging. The pain is pretty isolated to the outside of my leg, and I suspect there could be some impingement from the plate causing irritation.  The last piece here is that when I work on dorsiflexion (pushing knee over toe), I feel a blockage at that same point on the outside of my ankle, rather than a stretch in the Achilles as I would expect to experience. 

Thanks, Any and all thoughts are welcome. 

I don't know how applicable to your question this is, but my wife about 7 or 8 years ago broke the outer head of her left femur pretty much off. It was repaired with screws and plate. It has always been a problem, just a little at first, but more so every year. She has had re-evaluation periodically (2nd. 3rd, 4th opinions) done all the "rehab" when prescribed, in fact gone above and beyond consistently. All along, on occasion,  hardware removal has been discussed as a possibility. Bottom line is no one seems to know. They all just make statements based on?wtf?? Latest deal was yes get the hardware removed, and even had surgery scheduled. But two more opinions said be very careful, because the bone is now very weak because it has been supported by the hardware all these years. So she canceled the surgery. 

As far as I can tell,  in the rest of the world, the hardware gets removed shortly after the healing is done. The reason why seems clear. Maybe.

That's all I will say. Except,  I wish you good luck. Sincerely I do.

My story, your results may vary. I still have the plate on my fibula from a break in 2012 (Whiskey, testosterone and parkour) I did pretty bare minimum PT and as soon as I could start climbing (~5 months later) I stopped PT all together (as you might expect from a 20 something) I have since had many 100+ day seasons on a snowboard, run several ultra's and continue to progress in my climbing. The plate has never been a limiting factor, but I can definitely tell it's still there, some days more than others. Sounds like your putting in a lot more work than I did so I'm sure whatever your choice, you'll overcome. God's speed! 

Thanks for the responses!   I definitely resonate with the fact that there doesn’t seem to be a resounding yes or no from doctors on this. I definitely think getting the hardware out sooner makes sense after hearing that the bone starts to rely on the hardware so to say.  

And Tim, it’s good to hear just going on with life isn’t the worst, even if it is noticeable at times. I guess if I just have to stick to roadside cragging that’s not all bad.

I think I will lean towards getting it removed if my dr is not significantly against it.

And mostly, thanks for the good wishes :).  I made some comments when I first got injured on this site and got some great insight.  This is a solid community, even if some trolling happens here and there haha

Will your insurance pay for it? Some might not but if you are bothered by it and your doctor thinks it’s ok then it might be worth it. 

I think it will, so that is a silver lining I guess.  I think the main question I’m grappling with is whether or not the plate is the main cause of the irritation, or if it’s just lingering from the injury.  I’m sure it’s some combination of the two. If the plate is not the main cause though, having another surgery will just take time away from me hardening it up more.  (picture Tommy Caldwell decentizing his finger after the accident).

I've had a plate in my ankle since 92, it's only mildly painful at times and no worse then all of the other overuse injury's I live with. 

Tim, did it go through an initial phase where you had to get used to the feeling? Or where the pain reduced to the level it’s at?

btw, I saw you did the Cleveland route in the needles.  That’s wild.  Pete Cleveland was always a legend in devils lake climbing culture when I started climbing in Madison. 

TJ, initially I remember it hurting when anything bumped it, stiff and sore a lot but nothing I would call pain full time. My biggest thing was that I also had a severe dislocation, I could see the sole of the shoe, and that caused my biggest and second toes to buckle under. Several years latter I accidentally straightened the big one going OTB on the MTB dropping into a wash, stuck the landing on my feet but the big toe found a rock and I must have torn the tendon to make it straight. So that leaves the second toe buckled and even after 10 years of trying to make it straight with stretching it still a major pain. So I've always had some pain, but if your feeling a lot of pain from the plate it may well be that it needs to come out. Eventually I made it past the point where it could have been easily removed anyway, at this point I really can't feel it under the skin it's part of the bone now.

I was pretty wild for a few years there, never got much past 10+11- onsite leading but I felt solid on lower angle up to 5.9, Dennis Laughlin would always make a point to tell me there were no old bold climbers and he didn't think I would make it to 30. Eventually I got thru my soloing faze and started riding more and then got into whitewater, by the time I got back around to climbing I was content to lead 5.9 I the Sequoia Needles and gave up on soloing completely. Somehow I managed to make it to 60.

Also I have heard of a climber ripping a plate loose and having to have it removed in an emergency surgery, if yours is really hurting you don't want that to happen if it can be avoided.

Yikes, that sounds gnarly being able to see the sole of your foot! Yeah I think this injury is single handedly turning me from a (somewhat) bold climber to an aspiring old climber. This seems to ramp up whenever I do a bunch of activity on my feet, at this point I think it makes more sense to get it removed than to try to push through. Even just getting back to being able to do 5.9 in the needles sounds like a pretty awesome spot to be.

Although eight months seems like a long time it is actually on a normal time line for healing when a plate or device is installed. I had a fibula plate installed as a result of  a total ankle replacement and all the doctors I have been to say eight months for most bone regrowth and a full year for recovery as good as it will get. Mine will stay in. If your doc said anything less he might be misleading you. I had some screws in the ankle for years that only bothered me in poor fitting ski boots. What limited my climbing was scar tissue and range of motion and arthritis, which you may have in the future.Give it some time before you have more surgery and scar tissue.

Yeah the 1 year follow up was originally supposed to be when we discussed potential hardware removal.  Now that I’ve had some time to reflect (and hear from others on the forum and in life), I am less convinced the pain is a result of the plate by itself.  It was a nasty injury, and it’s gonna take time.  I am planning to back off and ramp back up to see if more gradual increase in activity will work better.  

Man it’s hard to take it slow…. 

TJ, I can definitively say that 30 years from the incident that brought the tibia plate, I have no pain.

Of course, you won't want it to take that long.