Risks and Responses of bone plate removal surgery

Although the bone plate removal surgery is a routine operation, there are still certain risks. The risks need to be reduced through preoperative assessment, meticulous operation during the operation and postoperative care. The following are the specific risks and countermeasures:

First, the main risks

Fracture again

Reason: During the process of removing the bone plate, the bone may suffer another fracture due to unexpected pressure or trauma, especially when the bone strength has not yet fully recovered, the risk is even higher.

Risk factors: Premature removal, osteoporosis, and premature weight-bearing after surgery.

Nerve injury

The reason is that the tissues around the bone plate may compress the nerves. If the operation is improper during the procedure, the nerves may be damaged, leading to postoperative sensory or motor dysfunction.

High-risk areas: such as the cervical vertebrae, brachial shaft, and small cranial heads, which are densely populated with nerves and blood vessels.

Bleeding

Reason: During the operation, the surrounding blood vessels may be damaged, leading to bleeding. In severe cases, it may cause hemorrhagic shock.

Risk factors: Vascular anatomical variations, unskilled surgical operations.

Infection

The reason is that the surgical incision may be contaminated by bacteria. When postoperative care is improper or the immune system is low, infection is prone to occur. In severe cases, it can lead to osteomyelitis.

Risk factors: Long operation time, lax aseptic operation, and improper postoperative wound care.

The problem of wound healing

Reason: After the operation, the wound may split open or heal delayed, etc. It needs to be treated promptly to avoid infection.

Residual internal fixator

Reason: During the operation, there may be a possibility of screw breakage or difficulty in removal, resulting in the retention of some internal fixators in the body, which may require a second operation.

Anesthesia risk

The reason is that the surgery requires anesthesia, which may cause allergic reactions, respiratory depression and other risks, especially for patients with poor overall condition and multiple underlying diseases.

Second, countermeasures

Preoperative assessment and preparation

Comprehensive examination: Before the operation, blood tests, electrocardiograms, etc. need to be conducted to assess whether the patient’s physical condition is suitable for the surgery.

Imaging examination: Confirm the healing of fractures through X-rays or CT scans to ensure sufficient bone strength.

Medication withdrawal preparation: Patients need to stop taking any medications that may affect the surgery in advance, such as anticoagulants and antiplatelet drugs.

Fine operation during the operation

Select an appropriate incision: Try to enter along the original incision as much as possible to minimize tissue damage.

Careful operation: Avoid damaging important structures such as peripheral nerves and blood vessels. Use special tools to carefully remove the bone plate.

Hemostasis measures: Timely hemostasis during the operation to reduce the risk of bleeding.

Postoperative care and rehabilitation

Wound care: Regularly change the dressing and disinfect. Observe the wound for any signs of infection such as redness, swelling, and exudation. Keep the wound clean and dry.

Rehabilitation training: Follow the doctor’s instructions for rehabilitation training to restore joint mobility and avoid premature weight-bearing.

Anti-infection treatment: If an infection occurs, antibiotics should be used promptly for treatment. If necessary, local incision and drainage should be performed.

Close monitoring and timely handling

Postoperative observation: Closely monitor the patient’s vital signs and wound conditions, and promptly detect and handle complications.

Psychological care: Pay attention to the patient’s psychological state, relieve tension and anxiety, and enhance confidence in recovery.

Third, handling of special circumstances

High-risk patients

Elderly people or those with concurrent internal diseases: The risk of removal surgery is relatively high. The necessity of the surgery should be carefully evaluated. If necessary, the removal should be postponed or conservative treatment should be adopted.

Internal fixings in special parts

Cervical vertebrae, pelvis and other areas: If the removal of the internal fixator is difficult to expose and is likely to damage important structures, and not removing it does not affect physical health, it can be considered not to remove it.

Small inner plants

Such as calcaneal rivets, carpal navicular double-headed pressure rivets, etc. : If their removal causes significant damage to the bone tissue, they may not be removed.