Should hardware be removed?

[Susan248]

I am writing about my 16 year old granddaughter.  
She fractured both ulna and radius midshaft in Aug 2010 playing volleyball.
Surgery was performed as open reduction and plates and screws were placed.
She is finishing up physical therapy.  Has had some pain at both fracture sites.
Have seen a specialist who said she routinely removes all hardware after
a year.
I have tried to do research on my own, and from what I can find out, there
seems to be debate about this.
I am concerned, I am worried about the future for her, and trying to avoid
further problems, or another fracture.
I appreciate any help you can give me.

[Michael L Gross, MD]

There really is no consensus with regard to removing hardware on the fracture is removed, except when it is causing discomfort.  If the hardware is painful, then it definitely needs to be removed.  Some feel that in young patients, hardware should be routinely removed because no one can say definitively if there is any long term effect from retaining it,
However, removing the hardware involves a second surgery and all the risks that go with it.  Also, the screw holes definitely represent a weaker area in the bone, at greater risk for fracture, until they fill in; if they ever really do.
Unfortunately, this is a decision that must be made on an individual basis by the patient and the treating surgeon.

[Michael L Gross, MD]

Yes. There all sorts of grafts that can be used, both natural and synthetic, but for the most part I don't think they are routinely used after removal of hardware

[Susan248]

Thank you for your timely and informative. I have one more question.  I have no idea if
this is even a possibility, but thought I would ask.
If hardware is removed, is there anyway to place anything into the screw holes to
fill them?  Any substance that can be used?
Thanks again for taking the time to help.