When a Broken Bone Needs More Than a Cast
Not every broken bone can heal on its own. When a fracture is displaced, unstable, or involves a joint, surgeons often need to use metal hardware to hold the bone in the correct position while it heals. This hardware includes plates, screws, rods, pins, and wires.
Surgical hardware is common after serious accident injuries. Car accidents, truck crashes, motorcycle wrecks, and falls all produce fractures severe enough to require surgical fixation. If you needed hardware after a fracture caused by someone else’s negligence, the cost, pain, and long-term impact of that hardware should be part of your injury claim.
Types of Surgical Hardware Used in Fracture Repair
Plates and Screws
This is the most common type of fracture hardware. The surgeon makes an incision over the fracture site, realigns the broken bone ends, and attaches a metal plate along the bone surface. Screws are drilled through the plate and into the bone to hold everything in place.
Plates and screws are used for fractures of the:
- Collarbone (clavicle)
- Forearm (radius and ulna)
- Wrist
- Ankle
- Shin (tibia)
- Pelvis
- Face and jaw
Modern plates are typically made of titanium or stainless steel. Titanium is lighter, stronger, and less likely to cause allergic reactions. Most plates are designed to stay in the body permanently, though some patients choose to have them removed after the bone has healed.
Intramedullary Rods (Nails)
An intramedullary rod is a long metal rod inserted through the center of the bone. It acts as an internal splint, holding the bone in alignment from the inside. Screws at each end of the rod lock it in place and prevent the bone from rotating.
Intramedullary rods are the standard treatment for fractures of the:
- Femur (thighbone)
- Tibia (shinbone)
- Humerus (upper arm bone)
The advantage of a rod is that it allows the patient to bear weight on the bone sooner than other fixation methods. The rod shares the load with the bone, reducing the risk of the hardware breaking during recovery.
External Fixators
An external fixator is a metal frame outside the body. Pins or wires are drilled through the skin and into the bone on either side of the fracture. These pins connect to the external frame, which holds the bone in alignment.
External fixators are used when:
- The fracture is open (compound) with significant soft tissue damage
- There is too much swelling for immediate internal fixation
- The fracture involves severe bone loss
- The patient has multiple injuries that prevent a long surgery
External fixators are often temporary. Once swelling goes down and soft tissues heal, the surgeon may replace the external fixator with internal plates, screws, or a rod. In some complex cases, the external fixator stays in place for weeks or months.
Pins and Wires
Thin metal pins (Kirschner wires or K-wires) are used for smaller fractures, particularly in the hand, wrist, foot, and elbow. They are inserted through the skin and into the bone fragments to hold them in place. Pins may stick out through the skin and are removed in the office once the bone has healed, usually after four to six weeks.
Cerclage wires are thin wires wrapped around or through bone fragments to hold them together. They are commonly used for patella (kneecap) fractures and some elbow fractures.
The Surgical Process
Fracture surgery is called open reduction and internal fixation (ORIF). “Open reduction” means the surgeon opens the skin to access the fracture and manually realigns the bone. “Internal fixation” means hardware is placed inside the body to hold the bone in place.
The surgery is performed under general anesthesia. Depending on the fracture, it can take one to several hours. Complex fractures involving multiple breaks or joint surfaces may require longer, more intricate procedures.
After surgery, the patient typically stays in the hospital for one to several days, depending on the severity of the injury and any other health issues. A cast, splint, or brace may be used for additional support during early healing.
Recovery After Hardware Placement
Recovery from fracture surgery with hardware is a long process. The timeline depends on which bone was broken, the severity of the fracture, and the patient’s overall health.
General recovery milestones:
- Weeks 1-2: Wound healing, pain management, limited movement
- Weeks 2-6: Gradual increase in activity, beginning of physical therapy
- Weeks 6-12: Bone healing progresses, increased weight-bearing and range of motion exercises
- Months 3-6: Continued strengthening, return to most daily activities
- Months 6-12: Full healing and maximum recovery for most fractures
Physical therapy is essential after hardware placement. Without it, joints stiffen and muscles weaken. Therapy can be painful, especially in the early stages, but it is critical for regaining function.
Problems and Complications with Surgical Hardware
While surgical hardware saves limbs and restores function, it is not without problems.
Hardware Irritation
Plates and screws near the skin surface can cause discomfort. This is especially common with collarbone plates, ankle plates, and wrist plates. The hardware may be visible or palpable under the skin. It can rub against tendons and cause pain with movement. Cold weather can make the area ache.
Hardware Failure
Plates can bend or break. Screws can loosen or back out. Rods can shift. Hardware failure usually happens when the patient puts too much stress on the bone before it has healed, or when the fracture is not healing properly. A broken plate or loose screw requires additional surgery to replace the hardware.
Infection
Any surgery carries a risk of infection. Infection around surgical hardware is particularly concerning because bacteria can form a biofilm on the metal surface that is resistant to antibiotics. Treating a hardware infection often requires removal of the hardware, weeks of intravenous antibiotics, and eventually a second surgery to replace the hardware once the infection clears.
Nonunion and Delayed Union
Sometimes the bone fails to heal even with hardware in place. This is called nonunion. Contributing factors include smoking, poor blood supply, infection, and inadequate fixation. Treatment for nonunion may include bone grafting (taking bone from another part of the body or using donor bone), revision surgery with different hardware, or bone stimulator devices.
Hardware Removal Surgery
Some patients eventually need or choose to have their hardware removed. Reasons include:
- Pain and irritation from the hardware
- Interference with normal activity or sports
- Allergic reaction to the metal (rare but possible)
- Hardware that has served its purpose and is no longer needed
- Growing children whose hardware may interfere with bone growth
Hardware removal is a separate surgery with its own risks, recovery time, and costs. It typically requires another round of physical therapy afterward.
The Cost of Surgical Hardware
Fracture surgery with hardware is expensive. A single ORIF procedure can cost $20,000 to $50,000 or more, depending on the bone involved, the complexity of the fracture, and the hospital. Intramedullary nailing of a femur fracture can exceed $40,000.
Additional costs include:
- Anesthesia: $1,000 to $3,000
- Hospital stay: $2,000 to $5,000 per day
- Physical therapy: $100 to $300 per session over several months
- Follow-up X-rays and office visits: $500 to $2,000
- Hardware removal surgery (if needed): $10,000 to $25,000
- Revision surgery for complications: $25,000 to $75,000 or more
When someone else’s negligence caused the fracture that required hardware, all of these costs are part of your injury claim.
How Hardware Affects Your Injury Claim
The presence of surgical hardware increases the value of a fracture injury claim for several reasons.
First, it proves the fracture was serious enough to require surgery. Insurance companies cannot minimize a fracture that required plates and screws.
Second, hardware means higher medical bills. The surgery, hospital stay, and extended recovery all add to the economic damages in your claim.
Third, hardware creates ongoing issues. Even after the bone heals, the hardware may cause discomfort, require removal, or limit your activities. These long-term consequences increase the value of your pain and suffering claim.
Fourth, hardware leaves scars. The surgical incision creates a permanent scar. If the hardware is visible or palpable under the skin, that is an additional form of disfigurement. Illinois law allows recovery for disfigurement.
Finally, the need for potential future surgery (hardware removal, revision) adds future medical costs to your claim. Your attorney should work with medical experts to project these future expenses.
Compensation You Can Recover
If you needed surgical hardware after a fracture caused by someone else’s negligence, you can seek compensation for:
- All past and future medical expenses, including surgery, hardware, therapy, and potential removal
- Lost wages during recovery
- Reduced earning capacity if the injury limits your work ability
- Pain and suffering from the fracture, surgery, and recovery
- Scarring and disfigurement
- Loss of enjoyment of life
- Emotional distress
The statute of limitations in Illinois is two years from the date of the accident. Do not delay in contacting an attorney.
Contact a Chicago Fracture Injury Lawyer
If you have plates, screws, rods, or other hardware in your body because of an accident someone else caused, you deserve full compensation. The surgery, the recovery, the scars, the ongoing discomfort. All of it matters.
A skilled injury attorney can calculate the full value of your claim, negotiate with insurance companies, and take your case to trial if necessary.
Call Phillips Law Offices at (312) 346-4262 or contact us online for a free consultation. We handle fracture and surgical hardware cases from accidents throughout Chicago and Illinois.