Abstract
BackgroundElective implant removal (IR) accounts for up to 30% of all orthopaedic surgeries. While there is general acceptance about the need of implant removal for obvious reasons, such as infections or implant failure, little is known about the beneficial aspects in cases of minor reasons such as patients’ wish for IR. Therefore, we initiated this study to define patients’ benefit of elective implant removal following plate osteosynthesis of displaced clavicle fractures.Patients and methodsProspective evaluation of patients was conducted before implant removal and 6 weeks postoperative. Subjective and objective criteria included pain rating on a visual analogue scale (VAS) and active range of motion (ROM) pre- and 6 weeks postoperative. Functional scoring included Constant-Murley Score, DASH (Disabilities of Arm, Shoulder and Hand Score), MSQ (Munich Shoulder Questionnaire) and SPADI (Shoulder Pain and Disability Index).Results37 patients were prospectively enrolled in this study and implant removal was performed after 16 ± 6.1 months. No re-fractures nor other complications were detected during routine follow up. Functional outcome increased through all scores (Constant score 73.3 ± 14.6 preoperative to 87.4 ± 12.0 postoperative (p = 0.000), MSQ 85.0 ± 7.3 preoperative to 91.8 ± 9.0 postoperative (p = 0.005), DASH Score 7.4 ± 8.2 preoperative to 5.7 ± 9.5 postoperative (p = 0.414), SPADI 93.4 ± 6.6 preoperative to 94.0 ± 10.1 postoperative (p = 0.734).ConclusionsDiscomfort during daily activities or performing sports as well as limited range of motion were the main reasons for patients’ wish for implant removal. We found increased functional outcome parameters and decreased irritation after implant removal. Therefore we suggest implant removal in case of patients’ wish and completed fracture consolidation.Trial registrationTrial registration no: NCT04343118, Retrospective registered: www.clinicaltrials.gov.
Highlights
Implant removal was performed after 16 ± 6.1 months
The mean Constant-Murley score increased from 73.3 ± 14.6 preoperative to 87.4 ± 12.0 postoperative
Mean DASH Score improved from 7.4 ± 8.2 preoperative to 5.7 ± 9.5 postoperative [p = 0.414, not statistical significant (n.s.)] as well as SPADI did from 93.4 ± 6.6 preoperative to 94.0 ± 10.1 postoperative (p = 0.734, n.s.), respectively Table 2
Summary
Elective implant removal (IR) accounts for up to 30% of all orthopaedic surgeries. While there is general acceptance about the need of implant removal for obvious reasons, such as infections or implant failure, little is known about the beneficial aspects in cases of minor reasons such as patients’ wish for IR. We initiated this study to define patients’ benefit of elective implant removal following plate osteosynthesis of displaced clavicle fractures. Conclusions Discomfort during daily activities or performing sports as well as limited range of motion were the main reasons for patients’ wish for implant removal. Elective implant removal for minor reasons, such as limited range of motion or a disturbing implant, is not proven to be beneficial overall [12, 13]. Implant removal accounts for up to 30% of all elective orthopaedic surgeries and rate of irritation followed by patients’ wish for IR is increasing [8, 9, 14], even though there is a clear lack of evidence about the substantial need of implant removal in consolidated fractures [15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
