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Veterinarni medicina2023; 68(7); 259-270; doi: 10.17221/52/2023-VETMED

Indications for the removal of implants after fracture healing: A comparison between human and veterinary medicine.

Abstract: Indications for implant removal after fracture healing are still under debate in both human and veterinary medicine. Although hardware removal is a common procedure, it should not be undertaken lightly. Intra and post-operative complications are common and a thorough evaluation of the risks and benefits should be performed. This review aimed to collect and summarise published data on the indications for implant removal in small animals, compare the collected data with human and equine medicine, and investigate the existence of guidelines for this purpose. There is no international consensual agreement for implant removal after fracture healing, neither in small animals nor in human orthopaedics. Decision-making processes are still controversial in some scenarios, thus clear evidence-based protocols for implant removal are needed.
Copyright: © 2023 Andrade et al.
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Publication Date: 2023-07-27 PubMed ID: 37982051PubMed Central: PMC10581530DOI: 10.17221/52/2023-VETMEDGoogle Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This research article reviews and compares the reasons for removing bone implants after fracture healing in both human and veterinary medicine, highlighting the lack of clear guidelines and consensus in this area.

Introduction

  • Implants such as screws, plates, and rods are commonly used to stabilize fractures in bones during healing.
  • Removal of these implants after the bone has healed is a frequent procedure but carries risks.
  • There remains ongoing debate about when and why implants should be removed in both humans and animals.

Aims of the Review

  • To collect and summarize existing data on the indications for implant removal specifically in small animals (pets like dogs and cats).
  • To compare these findings with data from human orthopedics and equine (horse) veterinary medicine.
  • To assess whether there are established clinical guidelines or consensus protocols for implant removal after fracture healing in any of these medical fields.

Findings: Lack of Consensus

  • Currently, there is no international or universally accepted agreement regarding when or whether to remove implants following fracture healing.
  • This absence of consensus applies to small animal veterinary medicine as well as human orthopedics.
  • In equine medicine, similar uncertainty and differing practices exist, though the article primarily focuses on small animals and humans.

Complications of Implant Removal

  • The surgery to remove implants is not without risks and can lead to intra-operative (during surgery) and post-operative (after surgery) complications.
  • These complications can sometimes be serious, prompting the need for careful risk-benefit analysis before attempting removal.
  • Complications may include infection, damage to surrounding tissues, refracture, or prolonged recovery time.

Clinical Decision Making

  • Decisions on implant removal are often based on individual patient factors, symptoms such as pain or irritation, implant-related problems, or owner/patient preference.
  • In many scenarios, the choice to remove hardware remains controversial due to lack of definitive evidence guiding best practices.
  • Surgeons and veterinarians must weigh risks and benefits on a case-by-case basis, sometimes without the support of clear evidence-based protocols.

Need for Evidence-Based Protocols

  • The review highlights the critical need for well-designed studies to develop evidence-based guidelines for implant removal.
  • Such protocols would help standardize care, improve patient outcomes, and reduce unnecessary surgery or complications.
  • Developing consensus would help both human and veterinary medicine practitioners make informed decisions regarding implant management post-fracture healing.

Conclusion

  • Implant removal after bone fracture healing remains a debated issue with no clear international guidelines.
  • The review underscores the importance of further research and consensus-building across both human and veterinary orthopedics.
  • Until then, careful evaluation and individualized decision-making remain essential to balance the risks and benefits of implant removal.

Cite This Article

APA
Andrade MC, De Rus Aznar I, Brunnberg M, Slunsky P. (2023). Indications for the removal of implants after fracture healing: A comparison between human and veterinary medicine. Vet Med (Praha), 68(7), 259-270. https://doi.org/10.17221/52/2023-VETMED

Publication

Veterinarni medicina
ISSN: 0375-8427
NlmUniqueID: 0063417
Country: Czech Republic
Language: English
Volume: 68
Issue: 7
Pages: 259-270

Researcher Affiliations

Andrade, Mario Candela
  • Department of Human Anatomy, Health and Medical University Potsdam, Potsdam, Brandenburg, Germany.
De Rus Aznar, Ignacio
  • Orthopaedic Surgery and Traumatology, University Hospital of Torrejón, Madrid, Spain; Shoulder and Knee Surgery Department, Olympia Quironsalud Hospital, Madrid, Spain.
Brunnberg, Mathias
  • Surgical Department, Small Animal Clinic, Tierarztpraxis Sörensen, Berlin, Germany.
Slunsky, Pavel
  • Surgical Department, Small Animal Hospital, Anicura Kleintierspezialisten Augsburg, Augsburg, Bavaria, Germany.

Conflict of Interest Statement

The authors declare no conflict of interest.

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Citations

This article has been cited 3 times.
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    doi: 10.3390/bioengineering12121358pubmed: 41463655google scholar: lookup
  2. Candela Andrade M, Petereit F, Slunsky P, de Rus Aznar I, Brunnberg L. Healing of Comminuted Fractures of Long Bones in Dogs.. Animals (Basel) 2025 Feb 2;15(3).
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  3. Candela Andrade M, Slunsky P, Pagel T, De Rus Aznar I, Brunnberg M, Brunnberg L. Microbial Colonization of Explants after Osteosynthesis in Small Animals: Incidence and Influencing Factors.. Vet Sci 2024 May 16;11(5).
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