With the development of medical technology and techniques, a large number of metal internal fixations (joints, titanium plates, screws…) are widely used in orthopedics. In orthopedics, they are widely used, so do you need to take out the internal fixation implanted in human body and when to take it out? Generally speaking, orthopedic internal fixation is divided into two types: “permanent” and “temporary”. “Permanent” internal fixation means that the human body always needs it to perform its function, most common such as artificial hip, knee joint, artificial intervertebral disc, etc. Under normal circumstances, they do not need to be removed, unless it is infected, damaged, worn, loose, broken, rejection or poor healing with the human body, or the same part needs to be reoperated, they They need to be removed only if they are obstructed. “Temporary” internal fixation is more often seen in fracture fixation and spinal fusion surgery, they theoretically have exercised their historical mission after fracture healing or complete spinal fusion, so they can be removed, but because most of the internal fixation is now titanium alloy, so in fact, when the patient does not request removal or due to other reasons can not be surgically removed. However, since most of the internal fixations are made of titanium, they can be removed for a long time if the patient does not want them removed or they cannot be removed surgically for other reasons. However, there are several cases that need to be taken out or removed earlier: loosening, breaking, or displacement of the internal fixation without fracture healing; infection of the internal fixation; re-fracture/lesion at the original fracture/surgical site or adjacent site, which requires further surgical treatment and the original internal fixation is obstructed; loosening, breaking, or displacement of the internal fixation before spinal fusion with clinical symptoms; internal fixation located on the body surface or under the skin, which can be removed. If the fixation is located on the surface of the body or under the skin, which affects the patient’s life due to friction; if the small amount of steel internal fixation affects the patient’s further MRI examination, etc. Is it necessary to take internal fixation or is it necessary to do it? No, it is not. As the internal fixation is also a surgery, there will be the same risks as the first surgery, such as anesthesia, bleeding, infection, surrounding tissue damage, etc., and because it is another surgery, so the anatomical structure of the surgical area has been disturbed and there is a lot of scar tissue, so it will not only bring great difficulties to the operator’s operation, but also sometimes the damage to the patient is great, such as some parts For example, some parts or surgery area is very close to the nerve, the risk of damaging the nerve in the first surgery is great, then the risk of damage will increase exponentially due to the scar cover adhesion, and because the internal fixation has been in the body for a period of time, so metal fatigue, fracture, material deformation, softening, and lead to removal difficulties, internal fixation residue or can not be removed is also very common. If the risk of removal is greater than the damage, then the doctor may advise the patient not to remove it. If the risk of re-fracture, nerve damage, or tendon damage is too great to risk, it will not be worth the cost. If the surgeon is unable to remove all of the internal fixation despite the best efforts of the surgeon, the patient may be advised not to insist on its removal because it will cause more damage. If there is a small amount of metal buried in the bone, which does not affect the activity and is asymptomatic, it is also not recommended to remove it, because that also means more damage. So what should the patient pay attention to before taking the internal fixation? 1, whether or not the internal fixation needs to be removed or when to take out the patient and the attending physician to fully communicate and decide together; 2, the best advice to patients to the first surgery medical institutions to take out the internal fixation, because the doctor will be more understanding of your surgery, the situation of the internal fixation; 3, if for various reasons must go to other medical institutions to do the internal fixation surgery, be sure to get the first surgery records and This is like a key to open a lock, if the medical institution does not have matching instruments, then it may lead to the failure of the operation; 4, fully understand and understand the risks of internal fixation surgery, weigh the pros and cons, fully communicate with the physician, and then decide whether to do the surgery.