Metal implant removal after consolidation of the malleolar fractures, I s worth it?

Authors

  • Susana Pinto
  • António Andrade
  • Carolina Tiago Afonso
  • Miguel Pinto de Freitas
  • Nuno Pais
  • Diana Pedrosa
  • Afonso Ruano

Keywords:

Ankle injuries/surgery, Device removal, Fracture fixation, internal

Abstract

Ankle fractures are a frequent injury, the treatment of which is most often open reduction and internal fixation. The removal of the material after consolidation is a common procedure but is not risk free and entails a significant associated cost. Although routinely performed in some hospitals, the indications for removal as well as the clinical benefit of this gesture are also still uncertain. Indeed, in this location the presence of material can lead to specific problems given the mechanical characteristics of the ankle and lack of surrounding tissue, however, local sensitivity and pain may also be caused by post-traumatic ankle changes. This study was designed to analyse the clinical benefits after removal of osteosynthesis material and expectations of symptomatic patients. Thirty patients with surgically treated malleolus fractures and with complaints related to the presence of metal implants were reviewed and the AOFAS and FAOS questionnaires were applied preoperatively and 3 months after the material extraction. Statistical analysis was performed using the Wilcoxon test and the results considered statistically significant if p<0,05. Most patients (67%) improved significantly after material extraction. There seems to be a clinical benefit in the extraction of the internal fixation material after consolidation, however, the patient must be correctly informed about the risks and expectations of this second operation.

Author Biographies

Susana Pinto

Programa de Residência em Ortopedia e Traumatologia, Unidade Local de Saúde do Nordeste EPE, Portugal.

António Andrade

Unidade Local de Saúde do Nordeste EPE, Portugal.

Carolina Tiago Afonso

Programa de Residência em Ortopedia e Traumatologia, Unidade Local de Saúde do Nordeste EPE, Portugal.

Miguel Pinto de Freitas

Programa de Residência em Ortopedia e Traumatologia, Unidade Local de Saúde do Nordeste EPE, Portugal.

Nuno Pais

Programa de Residência em Ortopedia e Traumatologia, Unidade Local de Saúde do Nordeste EPE, Portugal.

Diana Pedrosa

Programa de Residência em Ortopedia e Traumatologia, Unidade Local de Saúde do Nordeste EPE, Portugal.

Afonso Ruano

Serviço de Ortopedia, Unidade Local de Saúde do Nordeste EPE, Portugal.

Published

2018-07-20

How to Cite

Pinto, S., Andrade, A., Afonso, C. T., Freitas, M. P. de, Pais, N., Pedrosa, D., & Ruano, A. (2018). Metal implant removal after consolidation of the malleolar fractures, I s worth it?. Tobillo Y Pie, 10(1), 6–8. Retrieved from https://scijfootankle.emnuvens.com.br/tobilloypie/article/view/1321

Issue

Section

Original Articles