Fracture incidence following plate removal in Legg–Calvé–Perthes disease

Description: The decision of whether or not to remove pediatric metallic implants remains a controversial issue. Many factors have been cited both in favor and against routine removal of metallic implants. The purpose of this study was to determine the fracture rate following the routine removal of hardware from patients with Legg–Calvé–Perthes (LCP) disease treated by proximal femoral varus osteotomy (PFVO) and to determine if there is an optimal time to remove hardware in this population.
Conclusions Plate removal remains a reasonable choice but questions remain as to the timing of removal. These data suggest that patients may benefit from extending the time to hardware removal beyond radiographic union to at least six months or more after the osteotomy.
Fracture incidence following plate removal in Legg–Calvé–Perthes disease: a 32-year study Adam C. Schaaf, Dennis S. Weiner, Richard P. Steiner, Melanie A. Morscher, and Martin S. Dicintio J Child Orthop. 2008 October; 2(5): 381–385. Full text