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BMJ No 7119 Volume 315 Letters Saturday 22 November 1997 Patients with implants should be given implant cards for reference Editor Orthopaedics and trauma surgery would be unthinkable without implants. In Britain alone roughly 40,000 total hip implants are inserted every year. Then there are other joint implants, besides the metal plates, rods, nails, screws, etc that are used in fracture surgery. Thus millions of implants are inserted into bones and joints every year throughout the world. Other implants-for example, hormone implants and pacemakers-are also used. Some of these devices need to be removed when they have served their purpose or have failed. Removal of implants often leads to complications. Brown et al recorded a 19% complication rate following the removal of metal after fracture surgery alone.(1) The different types of implants used in various institutions show little uniformity. In the past couple of decades the Association of Osteosynthesis has standardised screws, plates, and nails, and this has certainly helped both surgeons and patients. But many manufacturers make implants. These metal devices are constantly being modified, which makes it difficult for a hospital to be equipped with all the different kinds of instruments required. There are many types of locking nails, for example, and the instruments necessary are not the same. Yet patients, having had their operations in a different country or hospital, go to their local hospital for follow up, often without any proper documentation. In such circumstances an implant card would be of immense value. This would detail the particulars of the patient, along with the date, site, and type of implant inserted or removed. Any other relevant comments and the manufacturer's name would be of added value. Implant cards given to patients would not only be a permanent record but also help hospitals to be equipped with the appropriate facilities when a patient needs further surgery. It should not cost a lot to introduce such cards. S Purkayastha Associate specialist Department of Orthopaedics, Bromley Hospitals NHS Trust, Bromley, Kent BR2 9AJ Reference 1 Brown R M, Wheelwrite E F, Chalmers J. Removal of metal implants after fracture surgery-indications and complications. J R Coll Surg Edinb 1993;38:98-100. Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline