Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Naumann, Markus George; Sigurdsen, Ulf; Utvåg, Stein Erik; Stavem, Knut

doi:10.1016/j.injury.2016.05.011

Cited by 35 publications

(18 citation statements)

References 31 publications

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“… 1 2 3 4 5 6 The exact incidence reported varies based on anatomic location and practice patterns. 7 8 9 10 Similarly, the recommended indications for implant removal differ between studies. Therefore, no consensus exists on the risks and benefits associated with implant removal.…”

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confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

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Introduction: The relative indications for removing symptomatic implants after osseous healing are not fully agreed on. The purpose of this study was to (1) determine whether patients showed improvement in functional outcomes after the removal of symptomatic orthopaedic implants, (2) compare the outcomes between upper and lower extremity implant removal, and (3) determine the rate of implant removal complications. Methods: A prospective study was conducted between 2013 and 2016. Patients completed a Short Musculoskeletal Function Assessment outcome questionnaire before implant removal and at the 6-month follow-up. Demographic data were stratified and compared between upper and lower extremity groups and between preimplant removal and 6-month postremoval. Results: Of the 119 patients included in the study, 85 (71.4%) were lower extremity and 34 (28.6%) were upper extremity. Significant improvement after implant removal was seen in the dysfunction index ( P ≤ 0.001), bother index ( P ≤ 0.001), and daily activities domain ( P ≤ 0.001). Depression or anxiety ( P = 0.016) were statistically significant predictors for an improved Short Musculoskeletal Function Assessment dysfunction index score at 6 months. The complication rate was 10.1% (n=12) for the cohort. Discussion: Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.

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confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

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“…Additionally, they showed that the majority of removals were due to symptomatic hardware. In Another retrospective study reported that about 17% of patients underwent hardware removal over a 3-year period (Naumann et al 2016).…”

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confidence: 99%

Reduced incidence and economic cost of hardware removal after ankle fracture surgery: a 20-year nationwide registry study

et al. 2020

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Background and purpose — Open reduction and internal fixation (ORIF) is a treatment method for unstable ankle fractures. During recent years, scientific evidence has shed light on surgical indications as well as on hardware removal. We assessed the incidence and trends of hardware removal procedures following ORIF of ankle fractures. Patients and methods — The study covered all patients 18 years of age and older who had an ankle fracture treated with ORIF in Finland between the years 1997 and 2016. Patient data were obtained from the Finnish National Hospital Discharge Register. Results — 68,865 patients had an ankle fracture treated with ORIF in Finland during the 20-year study period between 1997 and 2016. A hardware removal procedure was performed on 27% of patients (n = 18,648). The incidence of hardware removal procedures after ankle fracture decreased from 31 (95% CI 29–32) per 100,000 person-years in the highest year 2001 (n = 1,247) to 13 (CI 12–14) per 100,000 person-years in 2016 (n = 593). Moreover, the proportion and number of removal operations performed within the first 3 months also decreased. The costs of removal procedures decreased from approximately €994,000 in 2001 to €472,600 in 2016. Interpretation — Removal of hardware after ankle surgery (ORIF) is a common operation with substantial costs. However, the incidence and cost of removals decreased during the study period, with a particular decrease in hardware removal operations within 3 months.

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“…This study evaluated the postoperative outcome of patients submitted to SSR when compared with the group of patients who remained with SS. Several studies warned against routine implant removal after fracture healing, 5 , 6 , 13 , 14 and SSR is associated with potentially high complication rates. Furthermore, it cannot be predicted whether removal will result in functional improvement.…”

Section: Discussionmentioning

confidence: 99%

Supination-external rotation ankle fractures: analysis of clinical results after syndesmotic screw removal

Heck¹,

Guareschi²,

Silva³

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the postoperative results of patients with supination-external rotation ankle fractures who underwent syndesmotic screw (SS) removal.MethodsRetrospective cohort study assessing the late postoperative results of 35 patients operated from January 2013 to June 2015. Patients undergoing treatment of rupture of the distal tibiofibular syndesmosis with SS fixation and who did not have any concomitant surgical injuries in sites other than the ankle were included. Patients who did not complete appropriate follow-up after surgery were excluded from the study.ResultsThere was no statistical significant difference in the evaluated outcomes among the patients who had their SS removed and those who remained with the SS.ConclusionSS removal did not significantly alter the clinical results of patients surgically treated with SS for supination-external rotation fractures.

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Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Cited by 35 publications

References 31 publications

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Reduced incidence and economic cost of hardware removal after ankle fracture surgery: a 20-year nationwide registry study

Supination-external rotation ankle fractures: analysis of clinical results after syndesmotic screw removal

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