IR@PKUHSC  > 北京大学第三临床医学院
学科主题临床医学
Possible predictors for difficult removal of locking plates: A case-control study
Hou, Yun Fei; Zhou, Fang; Tian, Yun; Ji, Hong Quan; Zhang, Zhi Shan; Guo, Yan; Lv, Yang
关键词LCP LISS Difficult removal Correlated factors Prevention
刊名INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
2015-06-01
DOI10.1016/j.injury.2015.03.027
46期:6页:1161-1166
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Critical Care Medicine ; Emergency Medicine ; Orthopedics ; Surgery
研究领域[WOS]General & Internal Medicine ; Emergency Medicine ; Orthopedics ; Surgery
关键词[WOS]INVASIVE STABILIZATION SYSTEM ; HARDWARE REMOVAL ; IMPLANT REMOVAL ; FRACTURE ; TITANIUM ; COMPLICATIONS ; SCREW ; FIXATION ; FOREARM ; AGE
英文摘要

Introduction: Difficult removal of locking plates including less invasive stabilisation systems (LISSs) and locking compression plates (LCPs) sometimes occur. However, investigations of the mechanisms and correlated factors of complicated removal remain scant. This study aims to identify correlated factors for the difficult removal of locking plates and to propose suggestions for decision making regarding implant removal and the prevention of complicated removal.

Materials and methods: In total, 308 consecutive patients who underwent LCP/LISS removal from Sep. 2004 to Nov. 2013 were assessed. Using the Mann-Whitney U test, we analysed the correlation between difficult removal and the duration between open reduction and internal fixation (ORIF) and implant removal as well as the correlation between difficult removal and the patients′ age. Using Chi Square test, we assessed the correlations between complicated removal and the size, location, insertion technique and cortical purchase of the locking head screw (LHS). Correlated factors were separately determined in upper and lower extremities. Rates of difficult removal in different fracture locations were evaluated, and postoperative complications were documented.

Results: Of the total 308 patients, thirty-seven had intra-operative difficulties, and six patients experienced postoperative complications. Six out of fifteen patients with peri-elbow fractures and five out of seventeen patients with femur fractures suffered difficult removal, while four out of one hundred patients with malleolar fractures had intra-operative difficulties. Difficulties were experienced with 30 of 338 LCPs, 7 of 32 LISSs, 67 of 1533 small-diameter (<= 3.5-mm) LHSs, and 12 of 442 large-diameter (>= 4.5-mm) LHSs. Three LCPs and seventeen small-diameter LHSs were retained. A longer interval between ORIF and removal, younger age and bicortical screws correlated with difficult removal in the upper extremities, and a longer duration before removal, small-diameter LHS and minimally invasive insertion of LHS were predictors in the lower extremities.

Conclusions: Complications occur with LCP/LISS removal, and it should not be a routine procedure. If removal is indicated, performing surgery as soon as radiographs show fracture healing is recommended. Different considerations should apply when making decisions and removing implants from patients with different fracture sites. (C) 2015 Elsevier Ltd. All rights reserved.

语种英语
WOS记录号WOS:000355018800040
Citation statistics
Cited Times:2[WOS]   [WOS Record]     [Related Records in WOS]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/60284
Collection北京大学第三临床医学院
北京大学第一临床医学院_输血科
作者单位Peking Univ, Hosp 3, Orthoped Trauma, Beijing 100191, Peoples R China
Recommended Citation
GB/T 7714
Hou, Yun Fei,Zhou, Fang,Tian, Yun,et al. Possible predictors for difficult removal of locking plates: A case-control study[J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED,2015,46(6):1161-1166.
APA Hou, Yun Fei.,Zhou, Fang.,Tian, Yun.,Ji, Hong Quan.,Zhang, Zhi Shan.,...&Lv, Yang.(2015).Possible predictors for difficult removal of locking plates: A case-control study.INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED,46(6),1161-1166.
MLA Hou, Yun Fei,et al."Possible predictors for difficult removal of locking plates: A case-control study".INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 46.6(2015):1161-1166.
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