Abstract

• Debate continues whether removal of implants needs or not. It is difficulty to determine roentgenographically exactly whether healing is adequate. Additionally, in accordance with Wolffs law, bone becomes weaker because of stress shielding effect by implants. This fact becomes all too apparant why a well-united fracture is refractured by a minor injury following removal of implants. following surgery, except in unusual circumstances. After removal of implants, the use of a splint or a cast or a brace for at least a few weeks afterward is recommended. Recently, however, because every reoperation has potential complications such as wound infection, delayed healing, poor scar, neurologic problem and refracture, the trend is changed as removing only if they are causing significant symptoms. We experienced 6 cases of refracture among 114 patients who had removal of the implants from May 1986 to April 1990 at the department of orthopedic surgery, National Medical Center. The results were as follows ;
  1. The average time from insertion to removal was 11.7 months, with a ranged from 1.5 to 24 months.
  2. After removal of implants, immobilization with a long leg splint was utiliged in 2 cases, with a hip spica cast in 1 case, and with a crutch in 3 cases.
  3. The interval from of removal of implant to refeacture was 3.6 months, with a range from 1 to 8 months.
  4. Two of the refracture(case 2, 3) were successfully treated with operative methods and four with closed methods.
  5. Post-operative complications such as nerve palsy, infection after removal of implant were not seen.
  6. Factors affecting the refracture was degree of initial dis-placement, comminution, open wound, early removal, and lack of post-removal protection.
• Key words: Refracture, Implant removal

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