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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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A simple technique for removing a locking compression plate with a stripped locking screw.

Seok-Jung Kim¹, Min-Up Kim

¹Department of Orthopedic Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea. peter@catholic.ac.kr

Journal of Orthopaedic Trauma

|November 4, 2011

Summary

A novel technique effectively removes locking compression plates and stripped screws without special tools. This method involves drilling a new hole and using leverage to detach the plate and screw assembly.

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Surgical Techniques

Background:

Locking compression plates are widely used in fracture fixation.
Screw head stripping is a common complication during plate removal.
Existing methods for removing stripped screws can be complex or require specialized equipment.

Purpose of the Study:

To present a straightforward and accessible technique for removing locking compression plates with stripped screws.
To offer an alternative to specialized extraction devices for stripped screw removal.

Main Methods:

Loosen the bone-plate interface.
Drill a new hole adjacent to the stripped screw in the non-locking portion of the combination hole.
Apply leverage to the plate using an elevator after striking it along the line connecting the screw and the new hole.

Main Results:

The described technique successfully removed the locking compression plate with the stripped screw attached.
The method is applicable even when multiple screws are stripped.
No specialized tools beyond standard surgical instruments are required.

Conclusions:

This technique provides a simple, effective, and tool-sparing solution for removing locking compression plates with stripped screws.
It offers a valuable alternative for orthopedic surgeons facing this common intraoperative challenge.