Metal removal in a pediatric population: benign procedure or necessary evil?

Thirty-eight percent of patients with internal skeletal fixation had indications for removal other than uncomplicated healing. Plates were removed (p = 0.023) routinely, however, because intramedullary rods and staples were likely to be subcutaneous and painful (p = 0.02). Complications included incomplete removal of the device (7%) and two postoperative fractures. Most complications had no known significant adverse effects on the patients. Operative time and blood loss were significantly increased when a tourniquet could not be used. We believe that the high percentage of other indications for metal removal and the low incidence of major complications support the practice of routine metal removal in this population.