Surgeons' beliefs and perceptions about removal of orthopaedic implants

Abstract

Background: The routine removal of orthopaedic fixation devices after fracture healing remains an issue of debate. There are no evidence-based guidelines on this matter, and little is known on surgeons' practice and perceived effectiveness of implant removal in different clinical settings.

Removal of forearm plate leads to a high risk of refracture: decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture

“…Whether to remove the plate or not after bone union remains controversial [1]. Refracture has been reported in some studies [2][3][4][5][6][7], but only two articles have discussed the risk factors for refracture in adult forearm fractures after bone union [7,8]. The purpose of this study was to identify possible risk factors of refracture, which may help in decision-making regarding implant removal and thus prevent refracture.…”

Surface polishing positively influences ease of plate and screw removal

“…A recent survey suggests that approximately 42% of orthopedic surgeons routinely remove internal fixation devices (Hanson et al, 2008). In the United States, approximately 5% of planned orthopedic procedures involve removal of internal fixators (IF; Busam et al, 2006) while in Finland approximately 81% of implants are removed which accounts for 30% of all planned orthopedic procedures (Bostman and Pilhajamaki, 1996).…”

Indications for implant removal after fracture healing: a review of the literature

“…Though there are several presumed benefits of implant removal, like functional improvement and pain relief, the surgical procedure can be very challenging and may lead to complications such as neurovascular injury and refractures, whereas the expected outcome is not well determined yet. The (medical) indications for surgical removal of these metal implants are not well defined and a variety of view points with large differences in opinions and practices between surgeons, countries, patients, anatomical locations and implant materials exist [1][2][3][4][5][6]. There is a lack of clear guidelines concerning implant removal, only in Germany a more or less consensus based guideline exists [7].…”