Background: The aim of this survey study was to evaluate the current opinion and practice of trauma and\r\northopaedic surgeons in the Netherlands in the removal of implants after fracture healing.\r\nMethods: A web-based questionnaire consisting of 44 items was sent to all active members of the Dutch Trauma\r\nSociety and Dutch Orthopaedic Trauma Society to determine their habits and opinions about implant removal.\r\nResults: Though implant removal is not routinely done in the Netherlands, 89% of the Dutch surgeons agreed that\r\nimplant removal is a good option in case of pain or functional deficits. Also infection of the implant or bone is one\r\nof the main reasons for removing the implant (> 90%), while making money was a motivation for only 1% of the\r\nrespondents. In case of younger patients (< 40 years of age) only 34% of the surgeons agreed that metal implants\r\nshould always be removed in this category. Orthopaedic surgeons are more conservative and differ in their opinion\r\nabout this subject compared to general trauma surgeons (p = 0.002). Though the far majority removes elastic nails\r\nin children (95%).\r\nMost of the participants (56%) did not agree that leaving implants in is associated with an increased risk of\r\nfractures, infections, allergy or malignancy. Yet in case of the risk of fractures, residents all agreed to this statement\r\n(100%) whereas staff specialists disagreed for 71% (p < 0.001). According to 62% of the surgeons titanium plates are\r\nmore difficult to remove than stainless steel, but 47% did not consider them safer to leave in situ compared\r\nto stainless steel. The most mentioned postoperative complications were wound infection (37%), unpleasant\r\nscarring (24%) and postoperative hemorraghe (19%).\r\nConclusion: This survey indicates that there is no general opinion about implant removal after fracture healing\r\nwith a lack of policy guidelines in the Netherlands. In case of symptomatic patients a majority of the surgeons\r\nremoves the implant, but this is not standard practice for every surgeon
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