Technical complications during removal of locking screws from locking compression plates: a prospective multicenter
N Schwarz1, S Euler2, M Schlittler3
1Trauma Hospital Klagenfurt, Klagenfurt, Austria. nikolaus.schwarz@auva.at.
Summary
Removing titanium locking compression plates (LCPs) can lead to technical complications in about 20% of patients. However, most issues with jammed or damaged screws during LCP removal can be resolved with specialized instruments.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Surgical complication analysis
Background:
- Locking compression plates (LCPs) are widely used for fracture fixation.
- Implant removal is a common secondary procedure in orthopedic surgery.
- Technical challenges during removal can impact patient outcomes and surgical efficiency.
Purpose of the Study:
- To evaluate the incidence and nature of technical complications during the removal of titanium LCPs.
- To identify specific challenges associated with removing head locking screws.
- To assess the overall risk of technical issues in LCP explantation.
Main Methods:
- Prospective study involving 205 patients undergoing LCP removal across nine Austrian clinics.
- Detailed documentation of intraoperative technical complications and resolution methods by surgeons.
- Analysis of 1,462 locking screws removed from 204 LCPs.
Main Results:
- A 20.1% risk of at least one technical complication was observed during LCP removal.
- Common complications included jammed screws and damaged screw recesses, affecting 78 screws in 41 patients.
- Specialized instruments, such as extraction screws or drilling techniques, were effective in resolving most complications.
- One case of intraoperative refracture occurred, but clinical impact was minimal for most patients.
Conclusions:
- Titanium LCPs present a notable risk of technical complications during removal.
- The majority of removal complications can be successfully managed with specific surgical techniques.
- While complications occur, they often have limited clinical significance.
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