Management of Implant Failure in Long Bones and Its Functional Outcomes

Background: Implant failure in long bone fractures remains a significant complication in orthopaedic trauma practice and reflects an imbalance between mechanical stability and biological healing. Objective: To evaluate etiological factors, radiological findings, management strategies, and functional outcomes following revision surgery for implant failure. Methods: This prospective observational study included 50 adult patients with implant failure. Nonunion severity was assessed using the Nonunion Scoring System (NUSS). Pain was assessed using the Visual Analog Scale (VAS), and functional outcome was evaluated using the Katz Activities of Daily Living (ADL) score. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 20.0 (IBM Corp., Armonk, NY). Pearson correlation coefficient was applied for association analysis, with a p-value < 0.05 considered statistically significant. Results: The majority of patients were aged 31-50 years with male predominance (56%). Open fractures constituted 60% of cases. The tibia was the most commonly involved bone (32%). Implant breakage (26%) and loosening (22%) were the predominant modes of failure. Most failures occurred between three and six months (40%). The mean VAS score improved from 3.6 ± 1.2 preoperatively to 0.3 ± 0.2 at six months (p < 0.001). Eighty-two percent of patients achieved good-to-excellent functional outcomes. Conclusion: Implant failure is multifactorial in origin. A structured revision approach addressing both mechanical and biological factors results in favorable functional recovery.