Indications of implant removal: A retrospective study in a government tertiary care hospital

Abstract

Introduction: Metallic implant inserted for orthopedic fracture fixation may be removed for a variety of reasons. There is little consensus if such implant be removed routinely after fracture union. Hence, in our study, we would like to determine the indications for implant removal. Materials and Methods: This is a retrospective study of all cases of implant removal at the Orthopaedic Department of Mandya Institute of Medical Sciences, Mandya, Karnataka, India, from January 2019 to December 2020. Relevant information of patients were extracted and analyzed. Results: The study included 217 patients; there are 161 males and 56 females with a male-to-female ratio of 2.87. The peak age group is 16–30 years with a mean age group of 36.2 years. Distal tibia/ankle (15.66%) is the most common site for implant removal. Tibia (35.4%) is the most common bone. Plates and screws (38.7%) is the most common implant. Patients' request (31.7%) is the most common indication followed by surgeon request (25.8%), prominent hardware (21.6%), infection (17.5%), and failure (3.4%). About 37.7% of implants were removed before 12 months. Conclusion: Patients' request was the most common indication as they wanted implant to be removed and long-term effects of internal implant were not known. Surgeon request is the second most common indication, especially in the pediatric age. Prominent hardware was the third most common indication group as implants were impinging. Infection and implant failure were the other mandatory indications for implant removal.