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Elective removal of implants after open reduction and internal fixation of Tibial Plateau fractures improves clinical outcomes.
Garner, Matthew R; Thacher, Ryan R; Ni, Amelia; Berkes, Marschall B; Lorich, Dean G.
Afiliação
  • Garner MR; Hospital for Special Surgery, Weill Cornell Medical College, 35 East 70th Street, New York, NY, 10021, USA. garnermr@gmail.com.
  • Thacher RR; Hospital for Special Surgery, Weill Cornell Medical College, 35 East 70th Street, New York, NY, 10021, USA.
  • Ni A; Hospital for Special Surgery, Weill Cornell Medical College, 35 East 70th Street, New York, NY, 10021, USA.
  • Berkes MB; Landstuhl Regional Medical Center, Landstuhl, Germany.
  • Lorich DG; Hospital for Special Surgery, Weill Cornell Medical College, 35 East 70th Street, New York, NY, 10021, USA.
Arch Orthop Trauma Surg ; 135(11): 1491-6, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26264713
INTRODUCTION: Tibial plateau fractures are common injuries often treated with open reduction and internal fixation. We have noted improved patient satisfaction following implant removal for these patients. The purpose of this study was to assess the effect of removal of surgical implants after union on patient reported outcomes. MATERIALS AND METHODS: All patients at our Level 1 Trauma Center undergoing open reduction an internal fixation by the senior surgeon are offered enrollment into a prospective registry and have clinical outcomes recorded at follow-up [Knee Outcomes Survey (KOS), Lower Extremity Functional Scale (LEFS), Short Form-36 Physical and Mental Component Summary (SF-36 PCS, SF-36 MCS), and Visual analog pain scale (VAS)]. Routinely, removal of surgical implants is offered after fracture union resulting in two cohorts: those who had undergone elective removal of surgical implants and those who had not. Outcome scores were compared before and after implant removal as well as between the two study populations at final follow-up. RESULTS: Seventy-five patients were identified as having 12 month outcome scores: 36 (48%) had retained implants; 39 (52%) had implants removed. KOS and LEFS outcomes improved significantly after implant removal (p < 0.05). Clinical outcomes (KOS, SF-36 PCS) were also significantly better in patients who had implants removed compared to those that did not at final follow-up (p < 0.05). There was no statistical difference seen in VAS pain scores. CONCLUSIONS: The results of this study indicate that patients who have elective removal of their surgical implants after open reduction and internal fixation of a tibial plateau fracture have improved clinical outcomes after removal and also demonstrate significantly better outcomes than those who have retained implants at final follow-up. Patients who are unhappy with their clinical result should be counseled that removal of the implant may improve function, but may not improve pain.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Remoção de Dispositivo / Fixação Interna de Fraturas / Articulação do Joelho / Prótese do Joelho Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Remoção de Dispositivo / Fixação Interna de Fraturas / Articulação do Joelho / Prótese do Joelho Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article