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Complications during removal of conventional versus locked compression plates: is there a difference?

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Abstract

Background

Osteosynthesis plate removal is one of the most commonly performed procedures in orthopaedic surgery. Due to technological advances and the quality of increasing osteosynthesis material, more and more locked plates have been implanted over the last 20 years. The aim of this study was to determine whether the complication rate during plate removal differs between conventional and locked plates.

Material and methods

In this retrospective cohort study, 620 patients were included and divided into two groups based on the type of plate (locked and conventional). Technical complications during implant removal included screw breakage, destroyed screw head, implant breakage, remaining implant material, refracture, bony or soft tissue overgrowth. The following plate-associated complications were identified: osteosynthesis plate not detachable, plate bent or broken, necessity of special tools or plate loosened. Three types of screw-related complications were observed: screw not detachable, screw broken or screw dislocated.

Results

Overall, complications related to the plate or screws were documented in 110 of the 620 cases. These complications occurred in 48 of the 382 cases involving conventional osteosynthesis (7.7% of all removals, 12.6% of all conventional removals) and in 62 of the 238 cases involving locked plate osteosynthesis (10.0% of all removals, 26.1% of all locked plate removals). The statistical analysis showed a significantly higher implant-related complication rate with locked plates compared to the conventional plates (p < 0.01).

Conclusions

Hardware removal can be a complication-afflicted operation, especially cases involving locked-plate removal should only be performed if a strong indication is evident. Possible benefits of the procedure should be considered carefully, taking the cost-benefit ratio into account.

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Authors and Affiliations

  1. Department of Traumatology, Orthopaedics and Sports Traumatology, BG Trauma Hospital Hamburg, Bergedorfer Strasse 10, 21033, Hamburg, Germany

    Hanjo Neumann, Hinrich Heuer, Marc Auerswald & Benjamin Kienast

  2. Department of Orthopaedics and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck, Germany

    Anne Stadler, Justus Gille, Arndt Peter Schulz & Benjamin Kienast

Authors
  1. Hanjo Neumann
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  2. Anne Stadler
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  3. Hinrich Heuer
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  4. Marc Auerswald
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  5. Justus Gille
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  6. Arndt Peter Schulz
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  7. Benjamin Kienast
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Corresponding author

Correspondence to Benjamin Kienast.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

Informed consent was obtained from all individual participants included in the study. The study was approved by the ethical review board of the University of Luebeck, Germany (file number 13–177). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Neumann, H., Stadler, A., Heuer, H. et al. Complications during removal of conventional versus locked compression plates: is there a difference?. International Orthopaedics (SICOT) 41, 1513–1519 (2017). https://doi.org/10.1007/s00264-016-3352-7

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  • DOI: https://doi.org/10.1007/s00264-016-3352-7

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