ORIGINAL: Indications for Removal of Orthopaedic Implants in a Nigerian Tertiary Hospital: A Review of 128 Cases

West Afr J Med. 2021 Feb;38(2):166-170. PMID: 33641153

Abstract

Background: With expanding indications for operative fracture treatment, removal of orthopaedic implants has become a frequent elective orthopaedic procedure in developing countries. The clinical indications for implant removal are not well established and there are no specific indications despite the morbidity associated with implant removal operations.

Objective: To determine the frequency, indications and complications of removal of orthopaedic implants with a view to guiding implant removal protocol among surgeons.

Materials and methods: Retrospective data was obtained over a 5-year-period in NKST Rehabilitation Hospital, Mkar, Nigeria. One hundred and twenty-eight patients aged 4-88 years met the criteria for inclusion. Patients were followed up for at least 1 year and all complications recorded. Data was analysed using SPSS version 21.

Results: A total of 128 patients were studied. There were 84(55%) males and 44(45%) were females. The mean age was 40.0±15.5 years. The commonest indication for implant removal was infected implant in 29(22.6%) patients, followed by patient's demand 22(17.2%). Femoral plate was the commonest [29(22.6%)] implant removed, followed by tibia plate [20(15.6%)] and humeral shaft plate [7(5.5%)]. The mean duration of hospital stay was 21.7±24.1 days. Twenty-five (19.5%) patients had post-operative complications.

Conclusion: The commonest indication for implant removal was infected implant followed by patients demand. Femoral plate was the commonest implant removed. Post-operative complications included fractures, bleeding, nerve injuries and infection. Findings from this study suggest that implant removal operation may be associated with substantial morbidity. Therefore, not all orthopaedic implants require removal. Strict implant removal policy is advocated to guide the surgeon.