title: The case against routine metal removal.
abstract: Metal removal is one of the most commonly performed operations in pediatric orthopedics. Many of these operations are performed electively in asymptomatic patients. In a retrospective study of 138 patients who had metal removal operations, the indication for surgery was uncomplicated healing in 69%. The overall complication rate was 13%, including incomplete removal in 7% and refracture in 1.4% after metal removal. Operations to remove metal from the proximal femur were associated with the highest complication rates, especially in patients with slipped capital femoral epiphysis. In a comparison of the risks associated with metal removal operations and the risks of long-term metal retention, little evidence was found to support a policy of routinely removing asymptomatic implants after the completion of bone healing.
authors.affiliation: Children's Hospital, Richmond, Virginia.
authors.forename: W K
authors.initials: WK
authors.lastname: Kahle
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016268:Internal Fixators; D008297:Male; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012189:Retrospective Studies