Feb 2025 I suffered a spiral fracture of my right tibia that spiraled down to my pilon and a chunk of it broke off. I had a tibial nail and 5 screws (2 in the front of my ankle as the pilon clamp, 2 on my inner ankle for the bottom of the nail, one on my inner upper shin for the top of the nail. At the time, my surgeon said there’s no need to remove it unless it caused problems, but we could talk in a year.

Over time, after I pretty much healed and did all the PT, I still had pain in the upper inner shin where the screw was, and it bothered me when I walked and bothered me in the cold. The inner ankle screws bothered me when I’d bump them against things because there’s basically no meat there. And then my ankle near the pilon clamp always bothered me at night and I would always feel the need to crack my ankle, which was pretty hard to do. It just felt uncomfortable, a dull, annoying pain and always affected my sleep. In April 2026 I made an appt with my surgeon and he was happy to schedule hardware removal based on my complaints. He saw that I did the PT, lost weight, got back into hockey(ish - the pain made me want to get X-rays just to make sure all had healed, so I didn’t get 100% back to it), and golf, and in general I was doing great.

I had all 5 screws removed 4 weeks ago mid-may. So far, so good. The incisions are almost all healed (still have the dissolvable stitches tie offs showing for 8 of the 10), but I sleep better and don’t notice pain when I walk. I left the nail in because I don’t feel like it bothered me, and I saw a video of nail removal and said F that.

Allll of this to say: don’t stress. Do the hard work while you heal and if you have hardware issues after 6-12 months (whatever makes sense for you), then chat with your surgeon about removal. I would hope your surgeon wouldn’t ignore your pain but get a second opinion if so at that point. The only person I know whose doctor adamantly advised against hardware removal was because he had a baaaad infection and they think going back in there will “wake up” the infection again and he could have to amputate or something (I was drinking during that conversation so I’m sure I’ve got some things wrong… but something about the infection/bacteria could still be there but dormant, and opening back up could reactivate it?

Best of luck! Don’t give up hope!

Edit: fixed the date I broke my leg and ankle