Some clinical aspects of implant removal after healing of fractures of long bones of the extremities

Verkhovsky O.V.

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Some clinical aspects of implant removal after healing of fractures of long bones of the extremities

February 28, 2025

Orthopedics and Traumatology

Verkhovsky O.V.

УДК: 616.71-001.5:616.71-089

DOI: 10.32471/umj.1680-3051.263561

Keywords :

fractures of long bones of the extremities,

osteosynthesis,

removal of metal implants

Specialities :

Orthopedics and Traumatology

Resume

Removal of implants after osteosynthesis occupies a large share of the treatment of orthopedic patients. Today, there is no consensus on the feasibility and timing of such operations.

Objective: to evaluate the outcomes of metal implant removal used for the treatment of long bone fractures, considering different types and methods of fixation, depending on the time elapsed since implantation.

Materials and methods. The study analyzed the treatment outcomes of 197 patients who underwent orthopedic implant removal after fracture healing. Patients were categorized into two groups and three subgroups based on the type of bone fragment fixation: intramedullary locking osteosynthesis (compression, dynamic, and static) and metal plates (DCP and LCP). The analysis focused on clinical and radiological outcomes. The research methods included radiographic, clinical, analytical-statistical, and computed tomography assessments.

Results. Implant removal was performed without serious complications in the majority of patients. The most favorable treatment outcomes were observed in patients with intramedullary nails. The overall functional results were satisfactory; however, more than 20% of patients were not fully satisfied with the outcome of the surgery performed after 18 months from the primary implantation.

Conclusions. The removal of metallic implants should be considered a crucial stage in the treatment of long bone fractures after healing. The optimal timing for implant removal depends on the type of fixation used. The most significant differences in surgery duration, intraoperative complications, and patient satisfaction were observed after 18 months from the initial implantation. The outcomes for patients after intramedullary nail removal did not statistically differ based on the time elapsed since implantation. The highest occurrence of technical difficulties during surgery and the lowest patient satisfaction were observed in cases of LCP plate removal performed more than 18 months after the initial osteosynthesis. Surgical planning for LCP plate removal should be scheduled within 18 months after osteosynthesis.

References

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