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Published on: November 8, 2024

Implant removal associated complications in children with limb fractures due to trauma

E A Gorter, D I Vos, C F M Sier

    European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
    |December 31, 2011
    PubMed

    Insights

    Fracture implant removal in children, including Kirschner wires (K-wires) and elastic stable intramedullary nails (ESIN), is a safe procedure with low complication rates. Routine removal is indicated for K-wires and ESIN after fracture healing.

    Area of Science:

    • Pediatric Orthopedics
    • Trauma Surgery

    Background:

    • Fracture fixation in children often involves implants like Kirschner wires (K-wires), elastic stable intramedullary nails (ESIN), and screws.
    • The necessity and safety of routine implant removal after fracture healing in pediatric patients remain a subject of clinical inquiry.

    Purpose of the Study:

    • To analyze the incidence and types of complications following fracture implant removal in children.
    • To evaluate whether routine removal of orthopedic implants is advisable in pediatric trauma patients.

    Main Methods:

    • A retrospective analysis of patient records for children under 16 with limb fractures treated between 2000 and 2007.
    • Inclusion criteria focused on trauma-related fractures treated with K-wires, ESIN, or screw fixation, excluding refractures, pathological fractures, hand/foot fractures, and polytrauma.

    Main Results:

    • Out of 309 analyzed fractures, 17/173 K-wires and 7/96 ESINs had complications post-removal.
    • For screw fixation, 4/19 removals and 4/21 retained screws resulted in complications, with no significant difference between removal and retention groups.
    • Complication rates after removal surgery did not significantly differ among K-wire, ESIN, and screw fixation groups.

    Conclusions:

    • Implant removal, including K-wires, ESIN, and screws, is a safe procedure in pediatric patients.
    • Routine removal of K-wires and ESIN is indicated after fracture healing in children.
    • The decision for screw removal versus retention should be individualized based on complication risks.
    Abstract

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