• Yong Zhao, Bai-Wen Qi, Yao-Qing Wang, Di Liu, Fan Chen, Zhen Huang, and Zhen-Yu Pan.
• Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430072, China.
• Injury. 2018 Nov 1; 49 (11): 1999-2004.

AbstractHardware exposure following open reduction and internal fixation (ORIF) surgery is a tricky problem. It is always hard for surgeons to decide whether to keep or remove the hardware. In this study, a rating scale and corresponding clinical path is developed based on former published paper as well as our own experience. New admitted patients are first evaluated and scored once they enter the department. Based on the score they get, patients are assigned to different therapeutic schedule, i.e. (1) hardware preservation with pedicel flap transplantation, (2) debridement for further reevaluation and (3) hardware removal with external fixation. Satisfying clinical outcome is achieved that is characterized with high osseous consolidation rate and low complication rate. The result showed that this newly developed rating scale and the related therapeutic schedule could be an available tool to help surgeons to make decisions in the treatment of hardware exposure.Copyright © 2018 Elsevier Ltd. All rights reserved.

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