KUMJ | VOL. 11 | NO. 2 | ISSUE 42 | APRIL- JUNE, 2013
Epidemiological and Outcome Analysis of Orthopedic Implants Removal in Kathmandu University Hospital
Shrestha R, Shrestha D, Dhoju D, Parajuli N, Bhandari B, Kayastha SR
Abstract: Background
Orthopedic Implant removal is one of the commonly performed elective orthopedic
surgeries. Implants are generally removed after the purpose of keeping implant is
solved by healing of the fracture, but there is no consensus whether routine implant
removal should be a policy for all fractures that were fixed.
Objective
This study aims to analyze the epidemiology and outcome of implant removal surgery
carried out in the past three years in Kathmandu University Hospital.
Methods
Patients who underwent implant removal between 2010 January to 2012 December
constituted the study cohort. Demographic data, indications, types of hardware and
location of fractures were recorded. Similarly, duration of surgery, type of anesthesia
and duration of hospital stay were recorded. All the patients who had undergone
implant removal in this three years period were called for follow up examination but
those who were not able to come were interviewed on telephone.
Results
There were 275 implant removals constituting 7.8% of total orthopedic operations
and 26.3% of fracture fixations. Male to Female ratio was 189: 86. Pediatric age group
(34.5%) had the highest incidence of implant removal. Moderate sized implants were
the commonest hardwares removed (63.2%). Femur (27.3%) followed by radius
(26.9%) were the commonest bone for implant removal. Average operative time was
47.3 minutes with average hospital inpatient stay of 2.6 days. Commonest indication
for the implant removal procedure was pain (45%).
Conclusion
Implant removal procedures are one of the most commonly performed elective
orthopedic surgeries. Though, after orthopedic implants removal, pain relief can
be expected but it is not so predictive and hence patient should be well counseled
before and the indications for implant removal has to be evaluated for better patient
satisfaction and safety.
Keyword : Fracture Management, internal fixation, implant removal, orthopedic hardware, resurgery