|
|
|
|
Hardware RemovalHere is the abstract for one recent medical article on the subject of the removal of implant hardware. It certainly appears that the decision should not be taken lightly. Hardware Removal: Indications and ExpectationsReprint requests: Dr. Obremskey, Division of Orthopaedic Trauma, Vanderbilt University, Medical Center East, South Tower, Suite 4200, Nashville, TN 37232-8774. Although hardware removal is commonly done, it should not be considered a routine procedure. The decision to remove hardware has significant economic implications, including the costs of the procedure as well as possible work time lost for postoperative recovery. The clinical indications for implant removal are not well established. There are few definitive data to guide whether implant removal is appropriate. Implant removal may be challenging and lead to complications, such as neurovascular injury, refracture, or recurrence of deformity. When implants are removed for pain relief alone, the results are unpredictable and depend on both the implant type and its anatomic location. Current literature does not support the routine removal of implants to protect against allergy, carcinogenesis, or metal detection. Surgeons and patients should be aware of appropriate indications and have realistic expectations of the risks and benefits of implant removal. J Am Acad Orthop Surg, Vol 14, No 2, February
2006, 113-120. My Broken Hip Hardware Removal Experience - August 1, 2008Ever since my very serious fracture on December 15, 2005 I have experienced pain. After the bone healed the pain was centered in my soft tissues. I had muscle pain and finally bursitis that did not respond to any form of exercise, physical therapy or steroid injections. In addition, my iliotibial band (IT band - a ligament that runs from the top of the hip to below the knee to hold the leg together), was quite painful for a long time. The surgeon and I finally agreed that surgical removal of the lag screw in my hip, a bursectomy and an IT band release was the only course of action left. I have had few good nights sleep in the past 2.5 years because of the ongoing discomfort.
The image to the left is the pre-surgical x-ray showing how the lag screw protrudes from the side of my femur. It is about 4 and 3/4 inches long and about 7/16ths of an inch in diameter. That is what has been causing the ongoing pain. The long pin that runs the length of my femur is called a gamma nail and is about 17" long.
The picture below is the actual lag screw that was taken out with the palm of my hand and a dime for scale.
If you look really closely at the head of the gamma nail in the top photo you
can see the faint impressions of threads. That is actually a set screw that
locked the lag screw into place. That was a good thing because it helped to
keep my leg from shortening during the healing. Current designs do not
include the set screw.
I did not include the images of the incision that stared below the pin and
traveled up to the top of my hip. He had to open up the top of the gamma nail
and chisel out the bone to release the set screw. That took considerably more
chiseling than the screw. Yes, I could hear it all but rejected the offer of
more sedation. The good news was that the sedation made time fly and I had no
sensation of the fact that it actually took over 2 hours to get the job done.
Save up to 50% on medical equipment and home health care supplies from AllegroMedical.com.
Vital resources for managing your healthcare and recovering from a broken hip.
|
|
(c) 2006, 2008Steven C. Martin www.positive-way.com/recovery Permission for use: You may duplicate and use any or all of this material for non-commercial use without any further permission on the following two conditions: 1. the copyright information, my name and the website www.positive-way.com/recovery and 2. the following disclaimer must be included on every page. Your compliance is appreciated. |
