title: Metalwork removal in elective foot and ankle practice: does it make any difference to the patient?
abstract: BACKGROUND
  Increasing use of metalwork in foot and ankle surgery has led to an increasing number of subsequent surgeries for metalwork removal. The aim of the current study was to determine whether removing metalwork from foot and ankle makes any difference to the patients in terms of pain, function or shoe wear related outcomes.
  
  
  METHODS
  27 consecutive patients were identified from a single surgeon database that had undergone metalwork removal over a four year period and sent out a validated Visual Analogue Scale-Foot and Ankle questionnaire. Additional demographic and radiographic data were collected.
  
  
  RESULTS
  24 patients returned completed questionnaires. Mean interval between index procedure and metalwork removal was 18months. Overall for the whole group, only moderate satisfaction was noted after metalwork removal with mean VAS-FA scores of 60.39. The mean VAS-FA scores and the pain, function and other complaints sub-scores were significantly better in patients who had metalwork removal after 1st ray surgery (p=0.07 for total VAS-FA score and p=0.006, p=0.005, and p=0.032 for pain, function and other complaints sub-scores respectively).
  
  
  CONCLUSIONS
  We can recommend removal of metalwork in symptomatic patients after 1st ray surgeries but other foot and ankle surgeries require further investigation.
authors.affiliation: Dept of Orthopaedics, Royal Oldham Hospital, Rochdale Road, Oldham, United Kingdom. fdwadia@aol.com
authors.forename: F
authors.initials: F
authors.lastname: Wadia
authors.forename: M
authors.initials: M
authors.lastname: Sundar
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology; D020878:Device Removal / Q000379:methods* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000601:surgery*; D033023:Foot Joints / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome