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Complications of metalwork removal
P L Sanderson1, W Ryan, P G Turner
1Department of Traumatic and Orthopaedic Surgery, Stockport Infirmary, UK.
Injury
|January 1, 1992
Summary
Complication rates after orthopedic metalwork removal were 20%, with forearm fractures showing the highest rate (42%). Infection was most common in open fractures and after initial fixation, suggesting prophylactic antibiotic use.
Area of Science:
- Orthopedic surgery
- Trauma management
- Surgical outcomes
Background:
- Metalwork removal is a common orthopedic procedure.
- Complications can arise during and after hardware removal.
- Identifying risk factors for complications is crucial for patient safety.
Purpose of the Study:
- To determine the complication rate following the removal of orthopedic metalwork.
- To identify specific fracture types and circumstances associated with higher complication risks.
- To evaluate the nature and cause of complications, including nerve injuries.
Main Methods:
- Retrospective review of 188 patients undergoing metalwork removal.
- Analysis of complication rates stratified by fracture location and type.
- Detailed examination of infection rates in open fractures and post-internal fixation infections.
- Documentation of nerve injury etiology and outcomes.
Main Results:
- Overall complication rate was 20%.
- Forearm fractures exhibited the highest complication rate at 42%.
- Infection was the most frequent complication, with rates of 43% in originally open fractures and 32% in cases with post-fixation infection.
- All documented nerve injuries were permanent and attributed to junior surgeons.
Conclusions:
- Metalwork removal carries a significant complication risk, particularly for forearm fractures.
- Prophylactic antibiotics are recommended for patients with originally open fractures and those who develop infection after initial internal fixation.
- Nerve injuries during metalwork removal are permanent and associated with surgeon experience level.