During the period of January 1999 and August 2004 there was a policy in our institution of removal for metalwork from patients who underwent open reduction and internal fixation of an ankle fracture. We were not able to find any evidence in the literature as to whether implant removal confers long-term benefit or disability in these patients.

Between January 1999 to August 2003, all patients who underwent ankle metalwork removal were reviewed.

Most patients with mechanical symptoms were improved by implant removal. The two infections resolved. In those patients with pain, about two thirds found were improved.

Following this study the practice in our institution has changed. We do not feel routine removal of metalwork is warranted unless there are specific indications; mainly mechanical symptoms, infection and pain. We are particularly keen to counsel patients from the latter category, that surgery may not resolve their symptoms.