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Published on: December 3, 2017
Removal of deep extremity implants in children
J R Davids1, C Hydorn, C Dillingham
1Shriners Hospital, 950 West Faris Road, Greenville, SC 29605, USA. jdavids@shrinenet.org
Summary
Removing deep extremity orthopedic implants in children has a 12.5% complication rate. Specific patient factors, including prior complications and certain neuromuscular conditions, significantly increase the risk of major complications during removal.
Area of Science:
- Orthopaedic Surgery
- Pediatric Orthopaedics
- Surgical Complications
Background:
- Deep extremity orthopaedic implants are common in pediatric patients.
- Implant removal is a frequent procedure with potential risks.
- Understanding complication predictors is crucial for patient safety.
Purpose of the Study:
- To determine the rate and nature of complications associated with deep extremity orthopaedic implant removal in children.
- To identify risk factors predictive of complications during implant removal.
Main Methods:
- Retrospective review of 801 children undergoing 1223 implant removals over 17 years.
- Bivariate and logistic regression analyses to identify predictors of surgical complications.
- Calculation of risk ratios from logistic regression models.
Main Results:
- Overall complication rate of 12.5% (6.0% major, 6.5% minor).
- Predictors for major complications included prior implant insertion complications, non-elective removal indication, and specific neuromuscular conditions (seizure disorder, inability to walk).
- Children with all four predictors had a 14.6 times higher likelihood of major complications.
Conclusions:
- Deep extremity orthopaedic implant removal in children carries a notable complication risk.
- Identifying high-risk patients through specific clinical factors allows for targeted management and risk mitigation.
- Further research may focus on preventative strategies for high-risk pediatric populations undergoing implant removal.
