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Removal of the plate after a clavicle fracture is a logical conclusion to the treatment of this affected area, indicating the successful completion of the course.
Some patients, who feel much better after the successful installation of the metal insert, are in no hurry to dismantle it at the end of the validity period. But such amateur activity provokes serious complications, loss of efficiency and delayed negative consequences for the functioning of the clavicular zone.
Because of this, doctors insist on the need to strictly follow a pre-approved therapeutic program in order to remove their spent plate. It is better to do this in the same clinic where the initial installation was carried out. Ideally, the removal should be performed by the same surgeon, if possible.
There are cases when metal inserts fixed to the patient in one country could not be safely and quickly removed in another. The difference was based on the equipment used by advanced medical teams. It follows that it is better to carry out the intervention in the same medical institution on a hospital basis.
When is removal necessary?
The treatment of clavicular fractures has long advanced, eliminating the need to wear bulky plaster casts or even uncomfortable wooden splints for long periods.
Today, surgeons around the world prefer to use lighter designs for identical purposes, whether they be pins, full metal plates, or single high-strength screws. All of them are designed to speed up the recovery process after a serious injury to the collarbone.
Some innovative techniques provide the ability to introduce stable metal constructions directly into damaged bone structures. This allows you to securely fix their position in one position, which favorably affects the speed of splicing.
But the classic plates, which are sometimes installed together with adjacent screws for strength, are usually fixed on top of the bones. Their effect is about the same. The only difference is the type of initial injury. For the convenience of traumatologists, the developers of the methodology provided a separate classification for all metal fixators supplied to the medical market. They differ in size, purpose, types of fractures of the clavicular region.
Instead of suffering from uncomfortable plaster casts that drastically limit their usual activities, because even washing with them is difficult, patients now enjoy the benefits of high-strength plates. They have a number of advantages over outdated methods of helping fracture victims:
- increasing the mobility of the victim;
- reduction of the rehabilitation period;
- the opportunity to return to sports activities much earlier.
But for a successful return to normal life, even after a relatively simple clavicular fracture, you first need to get rid of the metal assistant. The reverse intervention is especially important if, during the examination, the doctor finds signs of a purulent process in the victim. This alignment indicates the inability of the body to accept a foreign body, even for good purposes, or inaccurately performed surgical intervention.
Another important reason for the need to get rid of the plate even before the time recommended by the doctor is often osteosynthesis. So in professional terminology they call unsatisfactory fixation of the bones, which indicates strong compression or too little pressure.
Clinical cases stand apart when the victim has an individual intolerance to the implant or an allergic reaction to its components. Here it will not be possible to conduct a full-fledged allergic test, since the body’s response may not immediately manifest itself. Because of this, the neutralization of a potentially dangerous device is an emergency indication.
If we are talking about an extensive fracture, which often entails additional damage to the ligaments of the acromioclavicular joint, then here, too, one cannot do without the installation of a special plate. But usually the operation is accompanied by additional installation of screws necessary to enhance the effect of fusion.
Damaged ligaments usually grow together, gaining their former performance, after about three months. Separately, it is worth making allowances for the fact that bone structures with fragmented versions of damage can heal much longer.
As soon as the restoration of all structures successfully comes to an end, it will be necessary to get rid of the previously introduced metal structure without fail. If you ignore such a doctor’s prescription, then the patient is likely to face a plate breakage in the near future.
The outcome is explained by the fact that certain devices are designed for a strictly specified operational period. Although they may continue to perform their assigned duties for longer, this will not lead to good.
Essence of extraction
The dismantling of the plates is necessary even if it is not a classic fracture, but a dislocation of the clavicle. In this case, it is most productive to use the strategy of applying an uncinate plate to the acromioclavicular joint.
If it is not removed in time later, then the victim is threatened with not the most beautiful scenario:
- development of arthrosis in the articular region;
- the formation of bone growths, which are called osteophytes;
- damage to muscle fibers by bone growths.
All of the above provokes a pronounced pain syndrome. Stopping it with analgesics without leveling the primary source of the problem is an ineffective solution. The pain will return and get worse over time.
Surgeons pay special attention to patients whose professional activities are closely related to sports achievements. Such people are at increased risk of getting a relapse at the same site. To reduce the percentage chance of repeating an identical injury, doctors insist on the need to remove the hardware immediately after confirmation of successful fusion. If you leave everything as it is, then with a repeated fracture, the presence of a metal retainer on the bone or inside it will significantly complicate the subsequent provision of assistance. Not to mention the slowdown in new healing after surgery.
Often, metal fixators that are not removed after the scheduled period become the reason for refusing a person for admission to military service. The same implants may be a contraindication to a number of other professional activities. To solve this problem, you will have to remove previously mounted parts, even if they have small dimensions.
For several decades, the indication for a second operation was the discovery of a fragment of a needle or drill, which is localized in the lesion.
This happened due to inaccurate intervention, as well as the use of home-made devices. They were often not adapted for these purposes, being made of completely weak alloys, which are not suitable for high loads by default. When they were deformed, small particles fell between the bones that were supposed to grow together, injuring the surrounding soft tissues, muscle fibers and even blood vessels. Damage to the latter threatens with extensive internal bleeding, which is quite difficult to diagnose with the naked eye.
You should not endure pain for those patients who seem to have had a successful operation to install the clavicular plates, but after a while it turned out that the foreign body causes significant pain. Discomfort is often caused by the fact that the head of the screw or staple interacts closely with the tendons.
As soon as the tendons begin to move even with a small action, the muscle begins to rub against the protruding part of the supporting mechanism. Most often, people with a thin physique have to deal with such inconveniences.
Also, all ladies who are planning a pregnancy, and have already successfully undergone fusion thanks to the plates, should be removed before conception. This will avoid latent negative options for influencing the fetus.
Planned and emergency removal
The decision on the date of the dismantling operation should be made only by the orthopedist after studying the results of the examination. X-rays, the current state of health of the patient are taken into account. If the visualization methods of the lesion demonstrate complete and correct union, then the only thing left is to remove the plates with screws.
If metal structures are located in the area of important nerve endings or large vessels, it is necessary to take into account the increased risks of re-fracture in the same place after the removal of the mechanism.
In medical practice, cases have also been recorded when victims were denied removal due to a number of serious chronic diseases. If the benefits of neutralizing the metal fixator do not exceed the risks in chronic ailments, then surgeons will not undertake such a dangerous business. Traditionally, such manipulations are carried out as planned after the person has completed all the preoperative stages with preliminary examinations. But there are a number of exceptions, providing for mandatory early extraction without a preparatory stage.
This concerns the migration of the latch with unreliable fasteners. When it begins to move towards vital organs or large vessels, the likelihood of damage to them increases. Not to mention the accompanying perforation of the skin. To protect the patient from the worst-case scenario, one has to go to extreme measures, carrying out a radical intervention urgently.
The same can happen if the victim found:
- deep suppuration;
- alloy material rejection;
- the formation of a false joint;
- the absence of callus, despite all the deadlines that have come out for this.
Despite the apparent simplicity, the removal of the rods is a laborious process that requires special skill of medical personnel.
During the manipulation, the doctor should always be ready for unforeseen situations, because the story when the hat is deformed and the slots are damaged when the mechanism is unscrewed is not such a rarity.
Due to the low-quality composition of medical “assistants”, a quite simple task often turns into an almost impossible one. In addition to the skills of the surgeon, special tools can help resolve the issue just for non-standard situations.
Rehabilitation period
If the hardware is located dangerously close to the nerve endings, this greatly increases the chances of complications. Because of this, some traumatologists insist on leaving the implant until better times.
But with acute indications for immediate removal, it is impossible to delay intervention even with life-threatening factors. It will be much more effective to involve a specialist in the field of microsurgery, who will cope with the neutralization of neurological disorders. The final verdict on a given topic is taken purely individually based on the results of a study of the health of the ward.
It is believed that removing the plate is a less traumatic measure than mounting it. To promote high-quality recovery from a fracture, doctors recommend strictly following the established protocol.
Do not assume that prolonged immobilization is a good solution to the problem. If you limit motor activity too much, it will only lead to atrophy or circulatory disorders. The destabilization of the latter function threatens the rapid development of a number of specific complications such as venous congestion, thrombosis and lymphostasis.
Schematically, the rehabilitation of such patients can be divided into two types of unequal duration: inpatient, outpatient. The first paragraph provides for the mandatory intake of prescribed drugs in the specified dose under the supervision of medical personnel. Medications are designed to block the pain syndrome. For the same purposes, movement therapy and procedures from the exercise therapy system are involved.
After you are discharged from the inpatient department of the hospital, the outpatient phase begins, which usually lasts about a year. The exact period can only be announced by the attending physician after studying the general dynamics of recovery.
To speed up the healing process, the victim will have to make every effort, because you will need to work on restoring natural blood circulation. You will also need to follow up with the exception of muscle atrophy and the restoration of motor function at its former level.
Physical activity within reasonable limits is best suited for the implementation of such a plan. This will overcome the initial stiffness of a person, and a positive effect will not be long in coming. And you should start with minor exercises, and then proportionally increase the load, focusing on your own feelings.