Internal fixation removal, although more common in the clinic, should never be taken lightly and should not be a routine procedure. Although removal of internal fixations is necessary in some cases, routine removal of internal fixations is not supported by the clinical literature. Patients who undergo internal fixation removal are exposed to certain nonessential risks and increased patient costs. Even in patients with reported pain associated with internal fixation, the pain may not be completely relieved after removal of the internal fixation, and in some patients it may even worsen; and there are more complications after removal of the internal fixation, such as infection, re-fracture, nerve damage, and increased pain. At this stage, there is no evidence of increased risk of tumor development in patients with retained internal fixation and stress masking at the site of retained internal fixation. The need to remove the internal fixation depends on the risk-benefit ratio of removing the internal fixation.