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Removal of internal fixation in pediatric patients
Adnan G Alzahrani1, Yaser M Behairy, Mohammad H Alhossan
1Department of Surgery, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Insights
Routine removal of internal fixation devices in pediatric patients is recommended. Timely removal of orthopedic implants in children avoids complications and difficulties associated with late removal.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Implant Removal
Background:
- Internal fixation devices are crucial in orthopedic surgery but can cause complications with prolonged presence.
- Routine removal of internal fixation is often advocated in pediatric patients.
Purpose of the Study:
- To evaluate the benefits and difficulties of removing internal fixation devices in pediatric patients.
- To assess the impact of timing on the ease of implant removal.
Main Methods:
- Retrospective analysis of 304 pediatric patients undergoing internal fixation removal.
- Data collected from January 1985 to December 1999 at Armed Forces Hospital, Riyadh.
Main Results:
- Mean age at removal was 11 years; average time post-implantation was 16.3 months.
- Late removal was more difficult than early removal.
- Implants in the hip and pelvis presented greater removal challenges.
Conclusions:
- Supports the indication for timely removal of internal fixation in pediatric patients.
- Routine removal can prevent complications and difficulties linked to delayed implant extraction.
Objective:
Internal fixation devices are commonly used in the surgical treatment of many orthopedic conditions. Their prolonged presence, however, has been associated with potential complications. Many surgeons advocate the routine removal of internal fixation in the pediatric age group. In this report we present our experience with removal of internal fixation in pediatric patients and evaluate the benefits and difficulties of doing so.
Methods:
A retrospective analysis of 304 pediatric patients who underwent removal of internal fixation implants for various indications at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia between January 1985 and December 1999, was carried out.
Results:
A total of 176 males and 128 females were included. Their mean age at time of removal of internal fixation was 11 years (range 2-18). The fixation device was removed at an average of 16.3 months (range 10-40) after implantation. One hundred and twenty (39.5%) patients had the initial fixation for the treatment of fractures. For all 304 patients, late removal of the implant was found to be more difficult than early removal. Implants around the hip and pelvis were more difficult to remove than other locations.
Conclusion:
Our experience supports the indication for timely removal of internal fixation devices in the pediatric population. When carried out on a routine basis it can avoid the difficulties associated with the late removal of implants.
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