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Hardware removal: indications and expectations.
Matthew L Busam1, Robert J Esther, William T Obremskey
1Department of Orthopaedics and Rehabilitation, Vanderbilt University, Nashville, TN, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|February 10, 2006
Summary
Hardware removal after bone fracture repair is not a routine procedure. Clinical indications are unclear, and removal carries risks like complications and unpredictable pain relief, necessitating careful consideration of risks versus benefits.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Hardware implantation is common for fracture fixation.
- Implant removal is frequently performed but lacks clear clinical indications.
Purpose of the Study:
- To evaluate the appropriateness of routine hardware removal.
- To review the risks, benefits, and economic implications of implant removal.
Main Methods:
- Literature review of studies on implant removal indications and outcomes.
- Analysis of potential complications and economic factors associated with hardware removal.
Main Results:
- Clinical indications for implant removal are not well-established.
- Removal can lead to complications (e.g., neurovascular injury, refracture) and unpredictable pain relief.
- Routine removal is not supported for allergy, carcinogenesis, or metal detection concerns.
Conclusions:
- Implant removal should not be considered routine.
- Surgeons and patients must weigh risks and benefits, considering specific indications and realistic expectations.