El ve Üst Ekstremite Cerrahisi Ameliyatlarında Kullanılan İmplantlar Ne Zaman Çıkarılmalı?

GİRİŞ ve AMAÇ: El cerrahisi ameliyatlarında internal fiksasyon olarak kullanılan implantların ne zaman çıkarılacağı amaçlandı. YÖNTEM ve GEREÇLER: Çalışmaya, Ocak 2019 ile Şubat 2021 tarihleri arasında retrospektif olarak Ortopedi ve Travmatoloji kliniği, El cerrahisi bölümünde cerrahi uygulanan 241 hastanın implantı çıkarılan 6 hasta (%2,4) ve 7 implant (4 erkek, 2 bayan) dahil edildi. Bu hastalarda uygulanan kırık ve/veya yanlış kaynama cerrahi tedavisi ile implant çıkarım ameliyatı arasındaki geçen süre değerlendirildi. İnternal fiksasyon olarak kullanılan implantların çıkarılma endikasyonları, çıkarılan bölgeler, sonrasında gelişen komplikasyonlar ve memnuniyet dereceleri değerlendirildi. Analiz Statistical Package for the Social Sciences (SPSS) ve Friedman’s p korelasyon testine göre yapıldı. p

What is The Right Time For Removal of İmplants İnserted During Hand and Upper Extremity Surgery?

INTRODUCTION: In this study,we aimed to investigate the most optimal removal time for the implants placed during internal fixation in the practice of hand surgery. METHODS: Of a total of 241 patients who underwent surgery in the Orthopedics and Traumatology,Hand Surgery Unit between January 2019 and February 2021, six (2.4%) whose implants were removed were retrospectively analyzed.There were seven implants in six patients (4 males, 2 females).Time from surgery for fractures and/or malunion to the implant removal was evaluated.Indications for implant removal, the removal sites, post-procedural complications, and patient satisfaction were assessed.Statistical analysis was performed using the SPSS software. Correlation analysis was carried out using the Friedman correlation analysis. A p value of

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1. Cronin PK, Watkins IT, Riedel M, Kaiser PB, Kwon JY. Implant removal matrix for the upper extremity orthopedic surgeon. Arch Bone Jt Surg 2020;8:99-111.
2. Snoddy MC, An TJ, Hooe BS, Kay HF, Lee DH, Pappas ND. Incidence and reasons for hardware removal following operative fixation of distal radius fractures. J Hand Surg Am 2015;40:505-7.
3. Trampuz A, Widmer AF. Infections associated with orthopedic implants. Curr Opin Infect Dis 2006;19:349-56.
4. Haseeb M, Butt MF, Altaf T, Muzaffar K, Gupta A, Jallu A. Indications of implant removal: A study of 83 cases. Int J Health Sci (Qassim) 2017;11:1-7.
5. Davids JR, Hydorn C, Dillingham C, Hardin JW, Pugh LI. Removal of deep extremity implants in children. J Bone Joint Surg Br 2010;92:1006-12.
6. Creighton Jr JJ, Steichen JB. Complications in phalangeal and metacarpal fracture management. Results of extensor tenolysis. Hand Clin 1994;10:111-6.
7. Onche II, Osagie OE, Inuhu S. Removal of orthopaedic implants: Indications, outcome and economic implications. J West Afr Coll Surg 2011;1:101-12.
8. Langkamer VG, Ackroyd CE. Removal of forearm plates. A review of the complications. J Bone Joint Surg Br 1990;72:601-4.
9. Yao CK, Lin KC, Tarng YW, Chang WN, Renn JH. Removal of forearm plate leads to a high risk of refracture: Decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture. Arch Orthop Trauma Surg 2014;134:1691-7.
10. Atwater AW, Reeder M. Hypersensitivity reactions to orthopedic implants: what’s all the hype? Cutis 2020;105:68-70.
11. Phedy P, Djaja YP, Boedijono DR, Wahyudi M, Silitonga J, Solichin I. Hypersensitivity to orthopaedic implant manifested as erythroderma: Timing of implant removal. Int J Surg Case Rep 2018;49:110-4.
12. Naumann MG, Sigurdsen U, Utvag SE, Stavem K. Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients. Injury 2017;47:1783-8.
13. Lutsky KF, Beredjiklian PK, Hioe S, Bilello J, Kim N, Matzon JL. Incidence of hardware removal following volar plate fixation of distal radius fracture. J Hand Surg Am 2015;40:2410-5. 14. Vos D, Verhofstad MHJ. Indications for implant removal after fracture healing: A review of the literature. Eur J Trauma Emerg Surg 2013;39:327-37.
15. Tan A, Chong A. Reasons for implant removal after distal radius fractures. J Hand Surg Asian Pac Vol 2016;21:321-5.
16. Minkowitz RB, Bhadsavle S, Walsh M, Egol KA. Removal of painful orthopaedic implants after fracture union. J Bone Joint Surg Am 2007;89:1906-12.
17. Abidi SA, Umer MF, Ashraf SM, Mehdi SH, Ahmed SK, Shaikh IA. Outcome of painful implant removal after fracture union. Pak J Surg 2012;28:114-7.
18. Reith G, Schmitz-Greven V, Hensel KO, Schneider MM, Tinschmann T, Bouillon B et al. Metal implant removal: benefits and drawbacks-a patient survey. BMC Surg 2015;15:96
19. Yılmaz B, Kömür B, Şirin E, Aktaş E, Yılmaz C, Heybeli N. İnternal fiksasyon amacı ile kullanılan plaklar kırık iyileşmesi süresince metal yapı ve özelliklerini ne ölçüde koruyabiliyor? Boğaziçi Tıp Dergisi 2019;6:18-21
20. Sanderson PL, Ryan W, Turner PG. Complications of metalwork removal. Injury 1992;23:29-30.