Sang Bong Ko; Seung-Bum Chae

doi:10.12671/jkfs.2016.29.2.101

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Original Article
Comparison of Quality of Life between Before and After Orthopaedic Implant Removal Surgery: Sang Bong Ko, M.D., Seung-Bum Chae, M.D.; Journal of the Korean Fracture Society 2016;29(2):101-106.
DOI: https://doi.org/10.12671/jkfs.2016.29.2.101
Published online: April 19, 2016

Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, Daegu, Korea.

Address reprint requests to: Seung-Bum Chae, M.D. Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea. Tel: 82-53-650-4283, Fax: 82-53-626-4272, sbchae@cu.ac.kr

• Received: May 9, 2015 • Revised: January 8, 2016 • Accepted: January 10, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study is to determine whether or not a patient's results are improved after removal of an internal fixative from a patient with no related symptoms.
Materials and Methods
This prospective study included 87 patients who agreed to participate in the study and satisfied the criteria for selection and exclusion of patients who underwent the operation for removal of internal fixative due to broken bones from March 1st, 2004 to December 31st, 2011 at Daegu Catholic University Medical Center. The average replication period was 27 months (12-64 months) and the average age at the time of the operation for removal was 41.5 years (21-75 years) for 55 males and 32 females. The quality of life for all patients was evaluated using Short Form 36 (SF-36) surveys before the operation for removal and after a minimum of one year.
Results
After an orthopedic operation for removal of internal fixative, physical health status showed statistically significant improvement (p=0.001); however mental health status did not (p=0.411). A satisfaction test for the subjective surgery written by patients indicated an improvement of subjective health status in 52.9% after the surgery for removal but with no difference in 29.9% compared to preoperation.
Conclusion
In case of an operation for removal of internal fixative for patients with no related symptoms with internal fixatives used for treatment of fractures showing agglutination opinions, an improvement was observed in physical health status, not in mental health status. When surgery for removal of internal fixative is performed for patients without related symptoms, consideration that subjective satisfaction of patients shows an improvement only in 52.9% will be helpful.
Key words: Orthopaedic implant, Removal surgery, Quality of life

None.

REFERENCES

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Table 1

Characteristics of Populations

Diagnosis	Treatment	No. of patient	Mean age (yr)	Mean F/U period (mo)
Clavicle fracture	ORIF with plate	2	25	25
Distal radius fracture	ORIF with plate	8	62.63	18.25
Femur shaft fracture	CRIF with IM nail	13	33.69	18.54
Femur condyle fracture	ORIF with plate	5	33.2	21
Forearm fracture	ORIF with plate	13	44.69	24.15
Olecranon fracture	ORIF with wire	2	53.5	28
Humerus shaft fracture	CRIF with IM nail	4	31	16.25
Humerus distal shaft fracture	ORIF with plate	5	25.8	21.4
Patellar fracture	ORIF with wire	9	44.11	17.67
Tibia shaft fracture	CRIF with IM nail	15	41.73	18.27
Tibia shaft fracture	ORIF with plate	11	47.73	26.91
Total		87	40.28	21.40

F/U: Follow-up, ORIF: Open reduction and internal fixation, CRIF: Closed reduction and internal fixation, IM nail: Intramedullary nail.

Table 2

Results of Functional Outcome

Variable	Pre-removal value	Post-removal value	p-value
PCS	61.3±18.2	64.4±17.1	0.001^*
PF	50.2±21.2	56.3±20.5	0.000^*†
RP	72.0±24.1	77.2±21.6	0.000^*†
BP	73.6±23.8	73.3±19.0	0.545^†
GH	51.2±21.2	57.3±18.4	0.000^*†
MCS	69.1±21.9	68.4±21.6	0.411^†
VT	59.2±20.3	60.9±20.0	0.010^†
SF	76.6±24.6	77.0±23.2	0.783^†
RE	73.2±32.3	67.4±35.9	0.011^*†
MH	67.3±18.9	68.3±19.7	0.076^†

Values are presented as mean±standard deviation. ^*p<0.05. ^† Wilcoxon sighed rank test was used for statistical analysis. PCS: Physical component score in Short Form 36 (SF-36), PF: Physical functioning, RP: Role limitation due to physical health problem, BP: Bodily pain, GH: General health, MCS: Mental component score in SF-36, VT: Vitality, SF: Social-functioning, RE: Role limitation due to emotional problems, MH: Mental health.

Table 3

Result of Item 2 Questionnaire

Variable	Number (%)
Much better	12 (13.8)
Somewhat better	34 (39.1)
About the same	26 (29.9)
Somewhat worse	11 (12.6)
Much worse	4 (4.6)
Total	87 (100)

Figure & Data

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Comparison of Quality of Life between Before and After Orthopaedic Implant Removal Surgery

J Korean Fract Soc. 2016;29(2):101-106. Published online April 30, 2016

DOI: https://doi.org/10.12671/jkfs.2016.29.2.101

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Comparison of Quality of Life between Before and After Orthopaedic Implant Removal Surgery

Table 1

Characteristics of Populations

Diagnosis	Treatment	No. of patient	Mean age (yr)	Mean F/U period (mo)
Clavicle fracture	ORIF with plate	2	25	25
Distal radius fracture	ORIF with plate	8	62.63	18.25
Femur shaft fracture	CRIF with IM nail	13	33.69	18.54
Femur condyle fracture	ORIF with plate	5	33.2	21
Forearm fracture	ORIF with plate	13	44.69	24.15
Olecranon fracture	ORIF with wire	2	53.5	28
Humerus shaft fracture	CRIF with IM nail	4	31	16.25
Humerus distal shaft fracture	ORIF with plate	5	25.8	21.4
Patellar fracture	ORIF with wire	9	44.11	17.67
Tibia shaft fracture	CRIF with IM nail	15	41.73	18.27
Tibia shaft fracture	ORIF with plate	11	47.73	26.91
Total		87	40.28	21.40

F/U: Follow-up, ORIF: Open reduction and internal fixation, CRIF: Closed reduction and internal fixation, IM nail: Intramedullary nail.

Table 2

Results of Functional Outcome

Variable	Pre-removal value	Post-removal value	p-value
PCS	61.3±18.2	64.4±17.1	0.001^*
PF	50.2±21.2	56.3±20.5	0.000^*†
RP	72.0±24.1	77.2±21.6	0.000^*†
BP	73.6±23.8	73.3±19.0	0.545^†
GH	51.2±21.2	57.3±18.4	0.000^*†
MCS	69.1±21.9	68.4±21.6	0.411^†
VT	59.2±20.3	60.9±20.0	0.010^†
SF	76.6±24.6	77.0±23.2	0.783^†
RE	73.2±32.3	67.4±35.9	0.011^*†
MH	67.3±18.9	68.3±19.7	0.076^†

Table 3

Result of Item 2 Questionnaire

Variable	Number (%)
Much better	12 (13.8)
Somewhat better	34 (39.1)
About the same	26 (29.9)
Somewhat worse	11 (12.6)
Much worse	4 (4.6)
Total	87 (100)

Table 1 Characteristics of Populations

F/U: Follow-up, ORIF: Open reduction and internal fixation, CRIF: Closed reduction and internal fixation, IM nail: Intramedullary nail.