Temporary awareness of hardware during swelling does not necessarily mean removal will be needed. Before attributing pain to a screw, the clinician should confirm bone union and exclude joint, nerve, scar or transfer-loading causes.
If removal is appropriate, it is usually delayed until the osteotomy has united adequately. Hardware removal is still an operation and carries risks including wound problems, infection, nerve irritation and temporary weakening around screw holes.
Do not assume all pain near a scar is caused by metal.
Use clinical examination and imaging to confirm hardware position and bone union.
Remove fixation only when expected benefit exceeds the risk of another procedure.
Can the body reject titanium screws?
True implant hypersensitivity is uncommon. Prominence, local irritation, infection or another pain source is generally more likely and should be assessed systematically.