背景:切开复位和内固定代表了普遍的骨科手术,引发了关于是否保留或移除无症状植入物的持续讨论。在这个问题上达成共识对于整形外科医生至关重要。本研究旨在量化常规植入物移除对患者和医疗机构的影响。对大学国王法哈德医院(KFHU)2016年至2022年的植入物移除病例进行了回顾性分析,并进行了统计审查。在这些案例中,44%的人需要住院超过一天,而56%的人只需要一天。成年人表现出55%的长期住院需求,相比之下,儿科队列中的22.8%。并发症发生率为6%,所有患者都经历至少一种并发症。值得注意的是,34.1%需要病假,4.8%超过14d。全身麻醉为主(88%)。常规移除植入物会导致不必要的并发症,尤其是成年人,可能延长住院时间。这个程序使医院资源紧张,绑住手术室,否则可以容纳关键手术。明确规定的机构准则对于规范这种做法至关重要。
目的:测量常规种植体摘除对患者和医院的负担。
方法:这是一项在KFHU治疗的167例常规植入物摘除病例的回顾性分析研究,沙特阿拉伯的一家三级医院。数据是从2016年2月至2022年8月在KFHU的骨科部门收集的,其中包括所有年龄段的常规无症状植入物移除病例。非常规适应症,如感染,疼痛,植入失败,malunion,骨不连,运动范围受限,突出的硬件被排除在外。移除外固定器或更换关节的患者也被排除在外。
结果:在2016年2月至2022年8月之间,共回收了360个植入物;但是,符合纳入标准的患者中只有167人被纳入本研究.剩余的植入物由于排除标准而被拒绝。在案件中,44%的人需要住院一天以上,而56%的人只需要一天。55%的成年人需要住院一天以上,而22.8%的儿科患者需要一天以上的住院护理。并发症发生率为6%,每位患者至少经历一次并发症。34.1%的个案需要病假,4.8%需要超过14d。手术中最常见的麻醉类型是全身麻醉(88%),平均(SD)手术时间为77.1(54.7)分钟。
结论:常规移除植入物会导致不必要的并发症,延长住院时间,耗尽资源,垄断可以为更关键的程序服务的手术室。
BACKGROUND: Open reduction and internal fixation represent prevalent orthopedic procedures, sparking ongoing discourse over whether to retain or remove asymptomatic implants. Achieving consensus on this matter is paramount for orthopedic surgeons. This study aims to quantify the impact of routine implant removal on patients and healthcare facilities. A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University (KFHU) was conducted and subjected to statistical scrutiny. Among these cases, 44% necessitated hospitalization exceeding one day, while 56% required only a single day. Adults exhibited a 55% need for extended hospital stays, contrasting with 22.8% among the pediatric cohort. The complication rate was 6%, with all patients experiencing at least one complication. Notably, 34.1% required sick leave and 4.8% exceeded 14 d. General anesthesia was predominant (88%). Routine implant removal introduces unwarranted complications, particularly in adults, potentially prolonging hospitalization. This procedure strains hospital resources, tying up the operating room that could otherwise accommodate critical surgeries. Clearly defined institutional guidelines are imperative to regulate this practice.
OBJECTIVE: To measure the burden of routine implant removal on the patients and hospital.
METHODS: This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU, a tertiary hospital in Saudi Arabia. Data were collected in the orthopedic department at KFHU from February 2016 to August 2022, which includes routine asymptomatic implant removal cases across all age categories. Nonroutine indications such as infection, pain, implant failure, malunion, nonunion, restricted range of motion, and prominent hardware were excluded. Patients who had external fixators removed or joints replaced were also excluded.
RESULTS: Between February 2016 and August 2022, 360 implants were retrieved; however, only 167 of those who met the inclusion criteria were included in this study. The remaining implants were rejected due to exclusion criteria. Among the cases, 44% required more than one day in the hospital, whereas 56% required only one day. 55% of adults required more than one day of hospitalization, while 22.8% of pediatric patients required more than one day of inpatient care. The complication rate was 6%, with each patient experiencing at least one complication. Sick leave was required in 34.1% of cases, with 4.8% requiring more than 14 d. The most common type of anesthesia used in the surgeries was general anesthesia (88%), and the mean (SD) surgery duration was 77.1 (54.7) min.
CONCLUSIONS: Routine implant removal causes unnecessary complications, prolongs hospital stays, depletes resources and monopolizing operating rooms that could serve more critical procedures.