A novel technique for pediatric femoral locked submuscular plate removal: the 'push-pull' technique

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Biomaterials and tissue engineering

Background:

• Minimally invasive plate insertion is increasingly used for pediatric fractures, offering smaller surgical footprints.
• Titanium implants in pediatric fractures can lead to fibrous and osseous ingrowth, potentially complicating implant removal.
• Standard implant removal may necessitate extensive open surgery, counteracting the benefits of initial minimally invasive procedures.

Purpose of the Study:

• To describe a minimally invasive surgical technique for removing titanium implants used in pediatric femoral fractures.
• To evaluate the efficacy and limitations of this technique in reducing complications associated with implant removal.

Main Methods:

• The study describes a novel surgical technique for minimally invasive implant removal.
• A case series of 21 pediatric patients with femoral fractures treated with this technique was analyzed.
• The procedure focuses on utilizing pre-existing incisions and maintaining control of the implant.

Main Results:

• The described technique facilitates implant removal through smaller exposures, minimizing soft tissue disruption.
• Successful removal was achieved in the case series, demonstrating the procedure's feasibility.
• Limitations of the technique were also noted, requiring further investigation.

Conclusions:

• Minimally invasive implant removal is an efficient and beneficial approach for pediatric fractures treated with titanium plates.
• This technique reduces operative morbidity, including soft tissue damage, bleeding, scarring, and pain.
• Further studies are warranted to fully establish the long-term outcomes and applicability of this method.