Related Experiment Video
Updated: Aug 18, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Pediatric fractures following implant removal: A systematic review
Anthony M Padgett1, Cole M Howie1, Thomas C Sanchez1
1Department of Orthopaedic Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA.
Insights
Postoperative fractures after orthopedic implant removal are a frequent complication in pediatric patients, occurring at rates up to 14.9%. Forearm and femur fractures are most common, highlighting the need for further research.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Biomedical Engineering
Background:
- Orthopedic implants are widely used in pediatric fracture management.
- Implant removal is a common procedure, but associated risks are not fully understood.
- Postoperative complications, particularly fractures, require careful evaluation.
Purpose of the Study:
- To systematically review the literature on postoperative fracture rates after orthopedic implant removal in children.
- To identify factors influencing fracture incidence and common fracture sites.
- To assess the current evidence base for this complication.
Main Methods:
- A systematic review of PubMed and Embase databases (January 2000-June 2022) was conducted following PRISMA guidelines.
- Included studies were randomized controlled trials, case-control studies, cohort studies, and case series involving pediatric patients.
- Data extraction focused on implant type, location, indication, fracture rates, and follow-up times.
Main Results:
- Fifteen studies were included in the qualitative synthesis.
- Reported fracture rates post-implant removal ranged from 0% to 14.9%.
- A meta-analysis could not be performed due to insufficient data.
Conclusions:
- Fracture following pediatric orthopedic implant removal is a significant concern.
- The forearm and femur are the most frequent sites for these fractures.
- Further high-quality studies are needed to elucidate contributing factors and guide clinical practice.
Objectives:
To evaluate the available literature for postoperative fracture rates following implant removal in the pediatric population.
Methods:
A systematic review of articles in the PubMed and Embase computerized literature databases from January 2000 to June 2022 was performed using PRISMA guidelines. Randomized controlled trials, case-control studies, cohort studies (retrospective and prospective), and case series involving pediatric patients that included data on fracture rate following removal of orthopedic implants were eligible for review. Two authors independently extracted data from selected studies for predefined data fields for implant type, anatomic location of the implant, indication for implantation, fracture or refracture rate following implant removal, mean time to implant removal, and mean follow-up time.
Results:
Fifteen studies were included for qualitative synthesis. Reported fracture rates following implant removal vary based on several factors, with an overall reported incidence of 0%-14.9%. The available literature did not offer sufficient data for conduction of a meta-analysis.
Conclusion:
Our systematic review demonstrates that fracture following implant removal in pediatric patients is a relatively frequent complication. In children, the forearm and femur are the most commonly reported sites of fracture following removal of implants. Traumatic fractures treated definitively with external fixation have the highest reported aggregate rate of refracture. Knowledge of the incidence of this risk is important for orthopedic surgeons. There remains a need for well-designed studies and trials to further clarify the roles of the variables that contribute to this complication.
More Related Videos
07:35Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
06:59Fracture Apparatus Design and Protocol Optimization for Closed-stabilized Fractures in Rodents
Published on: August 14, 2018
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:40Bone Remodeling