PROGRESS OF DIFFICULTY IN REMOVING OF LOCKING PLATE AND SCREW_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YINQudong , GUSanjun , SUNZhenzhong

Department of Orthopaedics, Wuxi No.9 People's Hospital, Wuxi Jiangsu, 214062, P. R. China;

Corresponding?author：

YINQudong, Email: yinqudong@sina.com

Keywords：

Removing of internal fixation; Complication; Stripping; Cross-threading; Cold-welding

DOI：

10.7507/1002-1892.20150081

Video：

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Objective To summarize the research progress of difficulty in removing of locking plate and screw. Methods The domestic and foreign related literature about difficulty in removing of locking plate and screw was reviewed. The incidence, the reason, preventive measure, removing method, and its advantages and disadvantages were summarized and analyzed. Results With the popularization of locking plate application, cases with difficulty in removing locking screw have significantly increased compared with non-locking plate, so it has become a new clinical problem. The main reasons are stripping, cross-threading, and cold-welding. In recent years, for the difficulty in removing of locking plate and screw, some special extraction tools and new extraction methods have developed, but each has its defects and indications. Conclusion Sufficient preoperative preparation, being familiar with its advantage and disadvantage as well as its indications are necessary. The specific situations of patient, including the reason, the screw, the plate, the incision, the bone quantity, and existing equipment, should be comprehensively considered to select appropriate methods.

Citation： YINQudong, GUSanjun, SUNZhenzhong. PROGRESS OF DIFFICULTY IN REMOVING OF LOCKING PLATE AND SCREW. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(3): 386-389. doi: 10.7507/1002-1892.20150081 Copy

1.	Sanderson PL, Ryan W, Turner PG. Complications of metalwork removal. Injury, 1992, 23(1):29-30.
2.	Georgiadis GM, Gove NK, Smith AD, et al. Removal of the less invasive stabilization system. J Orthop Trauma, 2004, 18(8):562-564.
3.	Cole PA, Zlowodzki M, Kregor PJ. Treatment of proximal tibia fractures using the less invasive stabilization system:surgical experience and early clinical results in 77 fractures. J Orthop Trauma, 2004, 18(8):528-535.
4.	Bae JH, Oh JK, Oh CW, et al. Technical difficulties of removal of locking screw after locking compression plating. Arch Orthop Trauma Surg, 2009, 129(1):91-95.
5.	Hamilton P, Doig S, Williamson O. Technical difficulty of metal removal after LISS plating. Injury, 2004, 35(6):626-628.
6.	Ehlinger M, Adam P, Simon P, et al. Technical difficulties in hardware removal in titanium compression plates with locking screws. Orthop Traumatol Surg Res, 2009, 95(5):373-376.
7.	Hak DJ, McElvany M. Removal of broken hardware. J Am Acad Orthop Surg, 2008, 16(2):113-120.
8.	Tan SL, Balogh ZJ. Indications and limitations of locked plating. Injury, 2009, 40(7):683-691.
9.	Raja S, Imbuldeniya AM, Garg S, et al. Difficulties encountered removing locked plates. Ann R Coll Surg Engl, 2012, 94(7):502-505.
10.	Hayes JS, Seidenglanz U, Pearce AI, et al. Surface polishing positively influences ease of plate and screw removal. Eur Cell Mater, 2010, 19:117-126.
11.	祝偉東. 鋼板螺釘內固定骨折術后取出困難的處理. 中國傷殘醫學, 2006, 14(1):34.
12.	雷曉晶. 鋼板螺釘取出困難應對策略. 中華創傷骨科雜志, 2007, 9(9):891-892.
13.	朱敏, 徐永清, 丁晶, 等. 一種取滑絲螺釘的方法. 中國骨與關節損傷雜志, 2012, 27(5):475.
14.	張國烈, 溫羨宏, 馮文參, 等. 鎖定鋼板螺釘取出困難原因及解決方法的探討. 臨床醫學工程, 2012, 19(2):210-211.
15.	楊明. 鋼板螺釘取出困難的應對方法(附24例報告). 江西醫藥, 2012, (12):1074-1075.
16.	Suzuki T, Smith WR, Stahel PF, et al. Technical problems and complications in the removal of the less invasive stabilization system. J Orthop Trauma, 2010, 24(6):369-373.
17.	Ehlinger M, Adam P, Simon P, et al. Technical difficulties in hardware removal in titanium compression plates with locking screws. Orthop Traumatol Surg Res, 2009, 95(5):373-376.
18.	付義春, 陳檢根. 改槽法在鋼板螺釘取出困難中的臨床應用. 臨床骨科雜志, 2010, 16(4):312-313.
19.	王書軍, 黃淦堂, 彭旭光, 等. 鋼板螺釘內固定術后取出困難之對策. 中國骨與關節損傷雜志, 2007, 22(8):699-701.
20.	Kumar G, Dunlop C. Case report:A technique to remove a jammed locking screw from a locking plate. Clin Orthop Relat Res, 2011, 469(2):613-616.
21.	Kim SJ, Kim MU. A simple technique for removing a locking compression plate with a stripped locking screw. J Orthop Trauma, 2012, 26(6):e51-53.
22.	Gopinathan NR, Dhillon MS, Kumar R. Surgical technique:Simple technique for removing a locking recon plate with damaged screw heads. Clin Orthop Relat Res, 2013, 471(5):1572-1575.
23.	Gupta R, Singh H, Singh A, et al. Hollow mill for extraction of stripped titanium screws:an easy, quick, and safe technique. Surg Tech Case Rep, 2014, 6(1):9-11.
24.	宋連新, 彭阿欽, 郝建東, 等. 骨折愈合后390枚鎖定螺釘取出術的研究分析. 中國矯形外科雜志, 2010, 19(18):1559-1562.
25.	王華溢, 楊重飛, 朱慶生, 等. 鎖定螺釘取出困難的原因分析及解決方案. 中國骨與關節損傷雜志, 2013, 28(3):292-293.
26.	徐亮, 朱海濤, 儲海軍, 等. 鎖定螺釘拆除困難的術中對策及初步原因分析. 中國骨與關節損傷雜志, 2010, 25(12):1139-1140.
27.	Maehara T, Moritani S, Ikuma H, et al. Difficulties in removal of the itanium locking plate in Japan. Injury, 2013, 44(8):1122-1126.
28.	吳佳俊, 朱越. 鎖定加壓鋼板及鎖定螺釘取出困難相關因素分析. 中華臨床醫師雜志(電子版), 2013, 7(24):394-395.
29.	H?ntzsch D, Stuby FM. Removal of plates and screws. Tips and tricks for problematic cases. Unfallchirurg, 2012, 115(4):291-298.
30.	Musters GD, van Hensbroek PB, Ponsen KJ, et al. Locking compression plates are more difficult to removethan conventional non-locking plates. Eur J Trauma Emerg Surg, 2013, 39(2):159-162.
31.	Lovald S, Mercer D, Hanson J, et al. Hardware removal after fracture fixation procedures in the femur. J Trauma Acute Care Surg, 2012, 72(1):282-287.

1. Sanderson PL, Ryan W, Turner PG. Complications of metalwork removal. Injury, 1992, 23(1):29-30.
2. Georgiadis GM, Gove NK, Smith AD, et al. Removal of the less invasive stabilization system. J Orthop Trauma, 2004, 18(8):562-564.
3. Cole PA, Zlowodzki M, Kregor PJ. Treatment of proximal tibia fractures using the less invasive stabilization system:surgical experience and early clinical results in 77 fractures. J Orthop Trauma, 2004, 18(8):528-535.
4. Bae JH, Oh JK, Oh CW, et al. Technical difficulties of removal of locking screw after locking compression plating. Arch Orthop Trauma Surg, 2009, 129(1):91-95.
5. Hamilton P, Doig S, Williamson O. Technical difficulty of metal removal after LISS plating. Injury, 2004, 35(6):626-628.
6. Ehlinger M, Adam P, Simon P, et al. Technical difficulties in hardware removal in titanium compression plates with locking screws. Orthop Traumatol Surg Res, 2009, 95(5):373-376.
7. Hak DJ, McElvany M. Removal of broken hardware. J Am Acad Orthop Surg, 2008, 16(2):113-120.
8. Tan SL, Balogh ZJ. Indications and limitations of locked plating. Injury, 2009, 40(7):683-691.
9. Raja S, Imbuldeniya AM, Garg S, et al. Difficulties encountered removing locked plates. Ann R Coll Surg Engl, 2012, 94(7):502-505.
10. Hayes JS, Seidenglanz U, Pearce AI, et al. Surface polishing positively influences ease of plate and screw removal. Eur Cell Mater, 2010, 19:117-126.
11. 祝偉東. 鋼板螺釘內固定骨折術后取出困難的處理. 中國傷殘醫學, 2006, 14(1):34.
12. 雷曉晶. 鋼板螺釘取出困難應對策略. 中華創傷骨科雜志, 2007, 9(9):891-892.
13. 朱敏, 徐永清, 丁晶, 等. 一種取滑絲螺釘的方法. 中國骨與關節損傷雜志, 2012, 27(5):475.
14. 張國烈, 溫羨宏, 馮文參, 等. 鎖定鋼板螺釘取出困難原因及解決方法的探討. 臨床醫學工程, 2012, 19(2):210-211.
15. 楊明. 鋼板螺釘取出困難的應對方法(附24例報告). 江西醫藥, 2012, (12):1074-1075.
16. Suzuki T, Smith WR, Stahel PF, et al. Technical problems and complications in the removal of the less invasive stabilization system. J Orthop Trauma, 2010, 24(6):369-373.
17. Ehlinger M, Adam P, Simon P, et al. Technical difficulties in hardware removal in titanium compression plates with locking screws. Orthop Traumatol Surg Res, 2009, 95(5):373-376.
18. 付義春, 陳檢根. 改槽法在鋼板螺釘取出困難中的臨床應用. 臨床骨科雜志, 2010, 16(4):312-313.
19. 王書軍, 黃淦堂, 彭旭光, 等. 鋼板螺釘內固定術后取出困難之對策. 中國骨與關節損傷雜志, 2007, 22(8):699-701.
20. Kumar G, Dunlop C. Case report:A technique to remove a jammed locking screw from a locking plate. Clin Orthop Relat Res, 2011, 469(2):613-616.
21. Kim SJ, Kim MU. A simple technique for removing a locking compression plate with a stripped locking screw. J Orthop Trauma, 2012, 26(6):e51-53.
22. Gopinathan NR, Dhillon MS, Kumar R. Surgical technique:Simple technique for removing a locking recon plate with damaged screw heads. Clin Orthop Relat Res, 2013, 471(5):1572-1575.
23. Gupta R, Singh H, Singh A, et al. Hollow mill for extraction of stripped titanium screws:an easy, quick, and safe technique. Surg Tech Case Rep, 2014, 6(1):9-11.
24. 宋連新, 彭阿欽, 郝建東, 等. 骨折愈合后390枚鎖定螺釘取出術的研究分析. 中國矯形外科雜志, 2010, 19(18):1559-1562.
25. 王華溢, 楊重飛, 朱慶生, 等. 鎖定螺釘取出困難的原因分析及解決方案. 中國骨與關節損傷雜志, 2013, 28(3):292-293.
26. 徐亮, 朱海濤, 儲海軍, 等. 鎖定螺釘拆除困難的術中對策及初步原因分析. 中國骨與關節損傷雜志, 2010, 25(12):1139-1140.
27. Maehara T, Moritani S, Ikuma H, et al. Difficulties in removal of the itanium locking plate in Japan. Injury, 2013, 44(8):1122-1126.
28. 吳佳俊, 朱越. 鎖定加壓鋼板及鎖定螺釘取出困難相關因素分析. 中華臨床醫師雜志(電子版), 2013, 7(24):394-395.
29. H?ntzsch D, Stuby FM. Removal of plates and screws. Tips and tricks for problematic cases. Unfallchirurg, 2012, 115(4):291-298.
30. Musters GD, van Hensbroek PB, Ponsen KJ, et al. Locking compression plates are more difficult to removethan conventional non-locking plates. Eur J Trauma Emerg Surg, 2013, 39(2):159-162.
31. Lovald S, Mercer D, Hanson J, et al. Hardware removal after fracture fixation procedures in the femur. J Trauma Acute Care Surg, 2012, 72(1):282-287.

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