Talk about the love story after taking out the steel plate

"Doctor, must the steel plate be taken out after the fracture?" Of course, this is uncertain. Compared with China, it is very common for foreign countries not to take the exam. Americans generally don't take 50%, and Britain may not take about 70%. People in China like to take everything.

1. Some specially designed internal fixing devices are unnecessary. For example, Herbert nails buried in articular cartilage do not need to be taken out abruptly, and there is no need to take them out.

2. Steel plates and nails are not recommended for special parts and special operations. For example, minimally invasive surgery for radial shaft fractures has small incision and little trauma to patients. It should be noted that there is a radial nerve nearby. When the steel plate is implanted, it passes under the radial nerve next to the bone, but it is not so easy to take it out without damaging the radial nerve. When the fracture of the middle and lower humerus13, if the nerve adheres to the steel plate, the rough removal of the steel plate will damage the radial nerve. If you have to take it, in order to avoid hurting the radial nerve, you need to make a relatively large incision.

Pelvic fracture, plate screw does not affect joint function, low-key, can not be removed. In addition, in order to clean up the surgical area, general anesthesia may be needed to lower blood pressure. If the three nails of femoral neck fracture are well combined with the bone, it is not recommended to take the nails. After taking the nail, the bone is not firm because the steel bar is taken out of the cement column.

There are many special situations in sports medicine surgery, which is the difference between us and orthopedics. For example, in recent years, many anchors have become absorbable through the improvement of technology and concept. For example, we sew the rotator cuff, fix the lower dead center of the anterior cruciate ligament, and fix the osteochondral fracture, including the anchor nail for fixing the fulcrum of the ankle ligament. Many of them have become absorbable and no metal anchor is needed anymore.

These anchors are buried deep in bones and tendons, even if they are metal, they can't be taken out. If it is taken out, the integrity of the tendon will be destroyed again, and the operation will be done in vain. Moreover, from the point of view of technical operability, it is almost an "impossible task" to obtain a few millimeters of anchor from the bone and ligament anchor.

After ACL reconstruction, it is completely unnecessary to take the fixing ring at the femoral end, because it is extremely small and deep, and it is very important to fix the ligament on the bone surface, and it is round and small, which does no harm to people. Under normal circumstances, it is impossible for patients to feel its existence. Moreover, in sports medicine surgery, we sometimes do a second arthroscopic exploration, which may require observing the healing of the reconstructed ligament and taking out the internal fixation of the tibial end by the way.

3. It is not recommended for the elderly. Because the elderly are generally in poor physical condition and have poor cardiopulmonary function, the risk of surgery and anesthesia is higher for them. If the steel plate is taken out simply for the sake of taking it out, there is no need to take the risk of taking it out.

4, surgery for many years, the steel plate has not been taken out for a long time, not recommended. Because of time, callus heals and wraps steel nails and steel plates, and the adhesion between steel nails and steel plates is easy to cause screw slippage. It is difficult to take it out at this time, and the surgical trauma will increase. Cold welding of LCP locking steel plate is common (cold welding of LCP steel plate), and sometimes the screw is tightly combined with the steel plate and cannot be taken out.