Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Dec;37(6):623-7.
doi: 10.1007/s00068-011-0087-4. Epub 2011 Mar 17.

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

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

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

E A Gorter et al. Eur J Trauma Emerg Surg. 2011 Dec.

Abstract

Purpose: The purpose of this study was to analyze the number and type of complications that occurred after fracture implant removal and to investigate whether implant removal should be performed routinely in children.

Methods: In a retrospective study, patient records were used for the analyses of patient characteristics, surgery reports, and complications. Children under the age of 16 years with a limb fracture due to trauma, treated with either Kirschner wires (K-wires), elastic stable intramedullary nails (ESIN), or screw fixation between 2000 and 2007, were included. Exclusion criteria were as follows: refracture, pathological fracture, fracture of the hands and feet, or polytrauma patients (Injury Severity Score [ISS] > 15).

Results: Three-hundred and nine fractures were analyzed. All K-wires (173) and ESIN (96) were removed as per standard procedure, resulting in 17/173 and 7/96 complications after removal, respectively. In 19/40 patients with screw fixation treatments, it was decided to remove the material after fracture consolidation, resulting in 4/19 complications. The decision in 21 treatments to leave the screw in situ led to four complications. No significant difference in complication rates could be found for the three groups after removal surgery (17/173, 7/96, and 4/19) or between hardware removal (4/19) and retention (4/21) in the case of screw fixation.

Conclusions: The removal of K-wires, ESIN, and screws is considered to be a safe procedure in children and is, by definition, indicated for K-wires and ESIN after fracture healing.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart of the study population. The bold numbers indicate the number of treated limb fractures
Fig. 2
Fig. 2
Fracture location and treatment of 309 fractures. The bold numbers indicate the number of fractures. The number and type of treatments for the specific fractures are given in italics
See this image and copyright information in PMC

References

    1. Alonso JE. Children’s fractures. In: Colton CL, Ferandez Dell’Oca A, Holz U, Kellam JF, Ochsner PE, editors. AO principles of fracture management. Stuttgart: Thieme; 2000. pp. 674–697.
    1. Kahle WK. The case against routine metal removal. J Pediatr Orthop. 1994;14(2):229–237. doi: 10.1097/01241398-199403000-00019. - DOI - PubMed
    1. Morshed S, Humphrey M, Corrales LA, Millett M, Hoffinger SA. Retention of flexible intramedullary nails following treatment of pediatric femur fractures. Arch Orthop Trauma Surg. 2007;127(7):509–514. doi: 10.1007/s00402-007-0286-y. - DOI - PubMed
    1. Simanovsky N, Tair MA, Simanovsky N, Porat S. Removal of flexible titanium nails in children. J Pediatr Orthop. 2006;26(2):188–192. doi: 10.1097/01.bpo.0000218534.51609.aa. - DOI - PubMed
    1. Hanson B, van der Werken C, Stengel D. Surgeons’ beliefs and perceptions about removal of orthopaedic implants. BMC Musculoskelet Disord. 2008;9:73. doi: 10.1186/1471-2474-9-73. - DOI - PMC - PubMed

LinkOut - more resources