Removal of metalwork (Removal of orthopaedic metalwork (implant removal))

An operation to take out metal plates, screws, nails or wires that were used to fix a broken bone after it has healed.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

It takes out metal plates, screws, nails or wires once a broken bone has healed.
It is usually done for a clear reason, such as the metal being felt, rubbing, or causing irritation or infection — not routinely.
Removing metal that causes no symptoms is generally not recommended, and surgery carries real risks including infection, nerve injury and re-fracture.
Pain relief is not guaranteed: many people feel better, but some feel no different and a few feel worse.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeOrthopaedic operation to remove implants

AnaestheticGeneral or regional anaesthetic, depending on the site

How long it takesVaries widely with the implant and its location

Hospital stayOften day case; sometimes one or more nights

Time off workVaries; often a few weeks, longer for leg or major implants

When you'll see resultsWounds heal over weeks; symptom relief is not guaranteed

On the NHS?Available on the NHS when there is a clear reason, not usually if you have no symptoms

A general guide. Your surgeon will give you advice for your situation.

Best fit

Can relieve discomfort caused by metal that is felt, rubs or catches

Pause if

The metalwork is causing no symptoms, where the risks of surgery usually outweigh any benefit.

Main recovery point

Expect pain, swelling and bruising around the wound. Use pain relief, keep the wound dry, and rest the area as advised.

Good aftercare

Clear advice on wound care and the warning signs of infection and re-fracture.

First few days

Expect pain, swelling and bruising around the wound. Use pain relief, keep the wound dry, and rest the area as...

First 1–2 weeks

Stitches or clips are usually removed at around 10–14 days. Many people with smaller upper-limb removals return to...

Weeks 2–6

Activity gradually increases. For leg or weight-bearing bones, you may be advised to limit loading and impact...

6 weeks to a few months

The bone continues to strengthen where screw holes remain. High-impact activity and contact sport are usually...

Medical line illustration of a cast and x-ray assessment for Removal of metalwork. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is removal of metalwork?

Removal of metalwork is an operation to take out the metal plates, screws, nails, pins or wires that were put in to hold a broken bone together while it healed. Once the bone has healed, the metal has done its job and is not always needed.

It is usually done because the metal is causing a problem — for example, it can be felt under the skin, it rubs or catches, it is irritating a tendon, or it is uncomfortable in cold weather or with activity. It is also sometimes removed because of infection, because it has loosened or broken, or to allow further planned surgery. In children, metalwork is more often removed to avoid interfering with growing bone.

Removing metal that is not causing any problem is generally not advised. Surgery has real risks, and there is no guarantee that taking the metal out will relieve symptoms — some people feel better, some feel no different, and a few feel worse.

It is important to go in with realistic expectations. If your main hope is pain relief, ask how likely that is for your particular situation, because the metal is not always the true cause of the pain.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Removal of plates and screws

Common after fractures fixed with a plate, for example around the ankle, wrist, collarbone or forearm. The old scar is usually reopened to reach the implant.

Removal of an intramedullary nail

A nail placed down the centre of a long bone (such as the thigh or shin) is removed, usually through small incisions at the ends of the bone.

Removal of wires, pins or screws

Smaller pieces of metal, such as wires (for example after some hand, wrist or kneecap fractures) or individual screws, can sometimes be removed through smaller cuts.

Removal for infection or loosening

If the metal is infected, loose or has broken, removal may be needed as part of treating the problem, sometimes alongside other surgery.

Removal in children

In children, metalwork is more often removed routinely, to avoid it interfering with growing bone or becoming buried and hard to remove later.

Remove the metal, or leave it?

Option	When it makes sense	Trade-off
Remove the metalwork	Metal is felt, rubs, irritates, is infected or loose	Another operation, with its own risks; relief not guaranteed
Leave the metalwork	No symptoms from the metal	Avoids surgery; metal stays, usually harmlessly
Wait and review	Mild or uncertain symptoms	Time to see if symptoms settle before deciding

Most modern implants can safely stay in for life if they cause no problems. Removal is usually for a clear reason, weighing the chance of relief against the risks of another operation.

Preparing for your surgery

Be clear with your surgeon about why you want the metal removed and what you hope to gain.
Ask how likely your specific symptoms are to improve, as pain relief is not guaranteed.
Make sure the bone has fully healed — removing metal too early risks the bone re-breaking.
Tell the team about your medicines, including blood thinners, and any other conditions.
Discuss the anaesthetic and how big the operation is for your particular implant.
Plan time off and help at home; recovery varies a lot by implant and location.
Arrange a lift home, especially if you have a general anaesthetic or it is a leg implant.

What happens

The operation is done under a general or regional anaesthetic, depending on the site and your preference. The previous scar is usually reopened, although smaller implants may come out through small cuts.

The surgeon locates and removes the metal, which can be straightforward or, sometimes, more difficult — screws can be stripped, metal can be partly covered by new bone, or an implant can break during removal. An X-ray may be used during or after the operation to check everything has been taken out.

How long it takes and how big the operation is depend on the implant and its location. Many removals are day-case procedures, but some need a longer operation and a hospital stay. The wound is closed with stitches or clips.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

The metalwork is causing no symptoms, where the risks of surgery usually outweigh any benefit.
The bone has not fully healed, so removing the metal risks the bone re-breaking.
Your pain is likely to have another cause that removal will not fix.
You are not fit for the anaesthetic or have conditions that strongly impair healing.
Removal would be very difficult or risky (for example, metal deeply covered by new bone) with little expected gain.

Delay surgery if…

The bone is not yet fully healed on X-ray.
You have an active skin or wound infection at the site (unless removal is part of treating infection).
Blood-thinning medicines need managing around surgery.
Your symptoms are mild or recent and might settle without surgery.
You have not had time to weigh the uncertain benefit against the risks.

Alternatives to discuss

Leaving the metalwork in place, which is safe for most modern implants if there are no symptoms.
Watchful waiting, to see whether mild symptoms settle.
Physiotherapy or activity changes for related stiffness or weakness.
Padding, footwear or clothing changes if the metal rubs.
Treating another cause of pain if the metal is not responsible.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

Common, especially for larger implants or deeper bones; you are fully asleep.

Regional anaesthetic

A nerve block or spinal can be used for some sites, numbing the limb while you stay awake or lightly sedated.

Benefits

Can relieve discomfort caused by metal that is felt, rubs or catches
Can settle irritation of nearby tendons or soft tissues
Is part of treating an infected, loose or broken implant
Removes a foreign material some people prefer not to keep
In children, avoids the metal interfering with growing bone

Risks & complications

More common

Pain and swelling around the wound for some weeks
A scar, often reopening the previous one
No improvement in symptoms in a proportion of people
A period of reduced activity while the wound and bone settle
Numbness around the wound

Less common

Wound healing problems
Wound or deeper infection, sometimes needing antibiotics or further surgery
Nerve injury causing numbness, tingling or weakness
Some metal being left behind if it cannot all be removed safely
Symptoms being no better, or occasionally worse, than before

Rare but serious

Re-fracture of the bone, during or after removal, especially of leg bones
Significant bleeding
Blood clots in the legs or lungs
Anaesthetic complications

The two most important points are that relief is not guaranteed, and that this is a real operation with real risks — including, for some bones, the bone breaking again after the metal comes out. The bone can be weaker for a time where screw holes remain. Ask your surgeon how likely your symptoms are to improve, how strong the bone will be afterwards, and what activity limits you will need.

Published figures to discuss

Outcomes vary with the implant, its location and the reason for removal. The figures below come from patient surveys and surgical series and are general guidance; whether your symptoms improve depends on whether the metal was truly the cause.

Figure	Reported range	How to interpret it	Source / confidence
Symptom (pain) relief after removal	Roughly half overall; higher (about 9 in 10) when removed specifically for pain	From a patient survey: many improve, but a substantial number report no change and a few are worse, even after uncomplicated surgery.	Guide sourcesClinical context
Overall complications	Around 1 in 10 in some series	Includes wound-healing problems, infection, nerve injury and re-fracture; varies with site and implant.	Removal of metal implants after fracture surgery — indications and complications (PubMed)pubmed.ncbi.nlm.nih.govPublished figure
Nerve injury or re-fracture	Uncommon, but recognised	Re-fracture is a particular concern for leg bones, where the bone is weaker for a time where screw holes remain.	Removal of metal implants after fracture surgery — indications and complications (PubMed)pubmed.ncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery depends a lot on which implant is removed and where. Smaller removals may need only a short recovery, while removing larger implants — especially from leg bones — needs more care, because the bone can be weaker for a while where the metal was.

First few days

Expect pain, swelling and bruising around the wound. Use pain relief, keep the wound dry, and rest the area as advised.

First 1–2 weeks

Stitches or clips are usually removed at around 10–14 days. Many people with smaller upper-limb removals return to light activity, but follow your surgeon's advice.

Weeks 2–6

Activity gradually increases. For leg or weight-bearing bones, you may be advised to limit loading and impact while the bone strengthens where the metal was.

6 weeks to a few months

The bone continues to strengthen where screw holes remain. High-impact activity and contact sport are usually reintroduced gradually, on your surgeon's advice.

What's normal — and not a worry

Pain, bruising and swelling around the wound for some weeks
Numbness around the scar
A period of taking it easy, especially for leg implants
Gradual return of normal activity
Realising that some original symptoms may remain

Aftercare

Keep the wound clean and dry, following advice on showering.
Take pain relief as advised, especially in the first days.
Follow any limits on weight-bearing, lifting or impact, particularly for leg bones.
Avoid high-impact activity and contact sport until cleared, to reduce re-fracture risk.
Watch for signs of infection and know who to contact.
Do not drive until you can safely control the car and are off strong painkillers.
Keep your follow-up appointment, including any X-ray check.

Before-surgery checklist

Pain relief ready at home
Wound care and dressing advice understood
Any weight-bearing or activity limits clear
Time off work organised to suit your job
Lift home arranged
Realistic expectation of symptom relief discussed
Clinic contact number saved for problems

Scars and how they heal

Removal usually reopens the original scar, so you should not gain many new scars, though the old one may be extended a little. Smaller implants may be removed through small new cuts. Scars can be firm and pink at first and settle over months; numbness around the scar is common.

⚠ Get urgent help if…

Spreading redness, heat, swelling or discharge from the wound, or a fever (possible infection)
Severe or increasing pain not helped by your painkillers
A new crack, snap or inability to use or bear weight on the limb (possible re-fracture) — seek urgent help
New numbness, tingling or weakness beyond the wound area
Calf pain or swelling, or sudden breathlessness or chest pain (possible clot) — seek urgent help
A wound that opens up or will not stop bleeding

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is relief of the symptom that led to surgery — for example, no longer feeling the metal under the skin, or less rubbing and irritation. When the metal was clearly the cause, many people are pleased they had it removed.

However, results are not guaranteed. Surveys of patients show that a meaningful number have no change in their pain even after a successful, uncomplicated operation, and a few feel worse. This is why being clear about the reason for surgery, and having realistic expectations, matters so much.

How long it lasts

Once the metal is out and the bone has fully strengthened, the result is generally lasting, and you do not need the metal back. The bone may be slightly weaker for a period where screw holes remain, so the main 'longevity' issue is protecting the bone from re-fracture until it has filled in, after which normal activity is usually fine.

Combining with other procedures

Removal is sometimes combined with other surgery — for example, to treat an infection, to release scar tissue, or as a planned step before another reconstructive operation. If so, your surgeon will explain how the procedures fit together and how recovery is affected.

Follow-up & long-term care

You will usually be reviewed in the weeks after surgery to check the wound, and an X-ray may be taken to confirm all the metal has been removed and the bone looks well. You should be given clear advice on when you can return to higher-impact activity. Tell your team if symptoms persist or new problems appear.

Protecting the bone from high impact until it has fully strengthened
A gradual return to sport or heavy activity as advised
Review if symptoms persist, suggesting another cause
General attention to bone and joint health

Revision and secondary surgery reality

Occasionally not all the metal can be removed, and a planned second attempt or acceptance of retained metal may be needed.
Re-fracture may need re-fixation, sometimes with new metalwork.
Wound or deep infection can need further surgery.
If symptoms persist after removal, the cause may need reassessing rather than more surgery.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear advice on wound care and the warning signs of infection and re-fracture.
An X-ray check that all intended metal has been removed.
Specific guidance on weight-bearing and return to impact activity.
A named contact for problems.
Honest review and reassessment if symptoms persist.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The surgeon's fee and the complexity of the removal
Which implant is being removed and its location
Anaesthetic fee (general or regional) and theatre/facility time
Whether it is a day case or needs an overnight stay
X-ray or imaging used during or after surgery
Physiotherapy if needed afterwards
Follow-up appointments

Make sure your written quote includes

The surgeon's fee and exactly which metalwork is being removed
Anaesthetist's fee and hospital/theatre charges
Whether it is day case or includes an overnight stay
Imaging during and after the procedure
Any physiotherapy and follow-up appointments
Cancellation policy
What happens — and who pays — if the metal cannot all be removed, or there is a complication such as re-fracture or infection

On the NHS? Removal of metalwork is available on the NHS when there is a clear clinical reason; removal of symptom-free metalwork is not usually offered, and some people choose private care for speed.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

What is the specific reason to remove my metalwork, and how likely is it to help my symptoms?
How big an operation is this for my particular implant, and what anaesthetic will I need?
How weak will the bone be afterwards, and what is my risk of re-fracture?
What activity limits will I have, and for how long?
What happens if the metal cannot all be removed safely?
Could my symptoms have another cause that removal will not fix?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Do I need to have my metalwork removed?

Usually only if it is causing a problem — such as being felt, rubbing, irritating tissues, or being infected or loose. Most modern implants can safely stay in for life if they cause no symptoms, so removal is not routine.

Will removing the metal get rid of my pain?

Maybe. Many people feel better, but pain relief is not guaranteed — some feel no different and a few feel worse, even after a successful operation. The metal is not always the true cause of the pain, so ask how likely relief is in your case.

Is it a big operation?

It varies a lot. Removing a small wire or screw can be minor, while removing a large plate or a nail from a leg bone is more involved and may need a hospital stay and a longer recovery.

Can the bone break again afterwards?

It can, especially in leg bones, because the bone is weaker for a time where the screw holes remain. Your surgeon will advise on limiting impact and high-risk activity until the bone has filled in.

What if the metal can't all be removed?

Occasionally a screw is stripped, an implant breaks, or metal is covered by new bone. Sometimes a small piece is safely left behind rather than risk more damage by removing it. Your surgeon should explain this possibility beforehand.

Is removal available on the NHS?

Yes, when there is a clear reason. Removal of metalwork that causes no symptoms is not usually offered. Some people choose private care for speed or convenience.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE CKS — Fractures (assessment and management) Metal implant removal: benefits and drawbacks — patient survey (PMC) Surgeons' beliefs and perceptions about removal of orthopaedic implants — PMC Indications of implant removal: a study of 83 cases — PMC Removal of metal implants after fracture surgery — indications and complications (PubMed)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.