Removal of metal after osteosynthesis. Indications and risks

This paper presents guidelines for indications, risks and technical aspects of removal of metal works. The indications comprise the general condition of patient, age, location of the implant, risks and disadvantages of the procedure. Problems concerning removal of metal are for example: lesions to nerves and re-fracture. Problems concerning maintain-ing the implant are for example: a compromise concerning necessary diagnostic procedures and late infections. In order to aid the decision making process two distinct groups of indications were applied. First, the definite indications, as for example disturbing implants as well as implants in the growing individual. Second, debatable indications, as for example removing screws from the femoral head, or implant-tissue-interactions. The issue of obtaining the consent of a patient to an operation, often not an operation for novice, may not be neglected. Lesions to nerves are amongst the most common complications. The technical guidelines refer to the specific locations and to the problem of broken intramedullary nails.