Operative Orthopadie und Traumatologie · 2026
[Practical guidelines for difficult and complex hardware removal in orthopedic surgery].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jordan Martin C, Bremer Justus, Al Refai Abdul, Wolff Felix, Wassilew Georgi I, Schoon Janosch, Zwingenberger Stefan, Heilig Philipp
Аннотация
OBJECTIVE: Safe and complete removal of osteosynthesis materials while preserving the surrounding soft tissues.
INDICATIONS: Indications include implant-related pain, soft-tissue irritation, infection, implant failure, pseudarthrosis, and risk to adjacent tendons, nerves, or vessels as well as implants in children.
CONTRAINDICATIONS: Disproportionate procedural risk in patients with poor bone quality, extensive scarring, or high surgical morbidity.
SURGICAL TECHNIQUE: Thorough preoperative planning, precise identification of the implant type and manufacturer, and the availability of the manufacturer's original extraction tools as well as alternative extraction instruments-such as special extractors, carbide drills, and hollow reamers-are essential. In this article, stepwise removal techniques are detailed for screws, plates, intramedullary nails, and spinal or pelvic implants, including strategies for managing stripped, cold-welded, or fractured implants.
POSTOPERATIVE MANAGEMENT: Early functional rehabilitation is encouraged. Following removal of load-bearing implants, temporary activity restrictions and postoperative X‑rays to detect iatrogenic fractures are recommended.
CLINICAL RELEVANCE: Implant removal is a frequent yet technically demanding procedure. Careful preparation, appropriate instrumentation, and meticulous technique reduce complications and enhance patient safety.
INDICATIONS: Indications include implant-related pain, soft-tissue irritation, infection, implant failure, pseudarthrosis, and risk to adjacent tendons, nerves, or vessels as well as implants in children.
CONTRAINDICATIONS: Disproportionate procedural risk in patients with poor bone quality, extensive scarring, or high surgical morbidity.
SURGICAL TECHNIQUE: Thorough preoperative planning, precise identification of the implant type and manufacturer, and the availability of the manufacturer's original extraction tools as well as alternative extraction instruments-such as special extractors, carbide drills, and hollow reamers-are essential. In this article, stepwise removal techniques are detailed for screws, plates, intramedullary nails, and spinal or pelvic implants, including strategies for managing stripped, cold-welded, or fractured implants.
POSTOPERATIVE MANAGEMENT: Early functional rehabilitation is encouraged. Following removal of load-bearing implants, temporary activity restrictions and postoperative X‑rays to detect iatrogenic fractures are recommended.
CLINICAL RELEVANCE: Implant removal is a frequent yet technically demanding procedure. Careful preparation, appropriate instrumentation, and meticulous technique reduce complications and enhance patient safety.