Priority 18 from the Complex Fractures PSP

UNCERTAINTY: Should metalwork routinely be removed after surgery and when?  (JLA PSP Priority 18)
Overall ranking 18
JLA question ID 0105/18
Explanatory note

Complex fractures may be treated using internal fixation with nails, plates, and screws. This metalwork may be left in situ forever or removed after a period of time. Some patients report problems with plates and screws close to the skin, ligaments, or tendons in areas such as the outside of the ankle. 


 No relevant guideline or trial evidence.

Health Research Classification System category Injuries and accidents
Extra information provided by this PSP
Original uncertainty examples Will screws need to be removed? ~ Need for metalwork to be removed due to reduced function with it still in situ ~ With the metal in for 12 months, mobility not as good as now with metal removed. Still swells up with long exercise. but generally good and able to do most things
Submitted by 3 x Patient 
PSP information
PSP unique ID 0105
PSP name Complex Fractures
Total number of uncertainties identified by this PSP. 58  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 8th June 2021