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Erschienen in: International Orthopaedics 8/2017

24.12.2016 | Original Paper

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

verfasst von: Hanjo Neumann, Anne Stadler, Hinrich Heuer, Marc Auerswald, Justus Gille, Arndt Peter Schulz, Benjamin Kienast

Erschienen in: International Orthopaedics | Ausgabe 8/2017

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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.
Literatur
2.
Zurück zum Zitat Wolter D, Jürgens C (2006) Winkelstabile verbindungen bei osteosyntheseimplantaten. Trauma Berufkrankh 8:206–211CrossRef Wolter D, Jürgens C (2006) Winkelstabile verbindungen bei osteosyntheseimplantaten. Trauma Berufkrankh 8:206–211CrossRef
3.
Zurück zum Zitat Seide K, Morlock MM, Schümann U, Wolter D (1999) Wirkprinzipien der winkelstabilen Platten-Schrauben-Verbindung bei Fixateur-interne-Osteosynthesen. Trauma Berufkrankh 1(4):320–325CrossRef Seide K, Morlock MM, Schümann U, Wolter D (1999) Wirkprinzipien der winkelstabilen Platten-Schrauben-Verbindung bei Fixateur-interne-Osteosynthesen. Trauma Berufkrankh 1(4):320–325CrossRef
5.
Zurück zum Zitat Voigt C, Lill H (2010) Winkelstabile implantate – fluch oder segen? Trauma Berufkrankh 12(Suppl 4):430–433CrossRef Voigt C, Lill H (2010) Winkelstabile implantate – fluch oder segen? Trauma Berufkrankh 12(Suppl 4):430–433CrossRef
7.
Zurück zum Zitat Wagner M, Frigg R (2006) AO manual of fracture management: internal fixators. Thieme, Stuttgart Wagner M, Frigg R (2006) AO manual of fracture management: internal fixators. Thieme, Stuttgart
10.
Zurück zum Zitat Wolter D, Jürgens C, Wenzl M, Schümann U, Seide K (2001) Titanfixateur-interne-Systeme mit multidirektionaler Winkelstabiler Schraubenlage. Trauma Berufkrankh Suppl 4:425–428 Wolter D, Jürgens C, Wenzl M, Schümann U, Seide K (2001) Titanfixateur-interne-Systeme mit multidirektionaler Winkelstabiler Schraubenlage. Trauma Berufkrankh Suppl 4:425–428
13.
Zurück zum Zitat Müller-Färber J, Blauth M, Stürmer KM (2008) Implantatentfernung. AWMF-Leitlinienregister Nr. 012/004 Müller-Färber J, Blauth M, Stürmer KM (2008) Implantatentfernung. AWMF-Leitlinienregister Nr. 012/004
14.
15.
Zurück zum Zitat Schildhauer TA (2007) Metallentfernungen Zu oft Routine - zu wenig Indikation? Trauma Berufkrankh 9(Suppl 3):292–296CrossRef Schildhauer TA (2007) Metallentfernungen Zu oft Routine - zu wenig Indikation? Trauma Berufkrankh 9(Suppl 3):292–296CrossRef
16.
Zurück zum Zitat Yao CK, Lin KC, Tarng YW, Chang WN, Renn JH (2014) Removal of forearm plate leads to a high risk of refracture: decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture. Arch Orthop Trauma Surg 134(12):1691–1697. doi:10.1007/s00402-014-2079-4 CrossRefPubMed Yao CK, Lin KC, Tarng YW, Chang WN, Renn JH (2014) Removal of forearm plate leads to a high risk of refracture: decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture. Arch Orthop Trauma Surg 134(12):1691–1697. doi:10.​1007/​s00402-014-2079-4 CrossRefPubMed
18.
Zurück zum Zitat Schwarz N, Euler S, Schlittler M, Ulbing T, Wilhelm P, Fronhöfer G, Irnstorfer M (2013) Technical complications during removal of locking screws from locking compression plates: a prospective multicenter study. Eur J Trauma Emerg Surg 39(4):339–344. doi:10.1007/s00068-013-0301-7 CrossRefPubMed Schwarz N, Euler S, Schlittler M, Ulbing T, Wilhelm P, Fronhöfer G, Irnstorfer M (2013) Technical complications during removal of locking screws from locking compression plates: a prospective multicenter study. Eur J Trauma Emerg Surg 39(4):339–344. doi:10.​1007/​s00068-013-0301-7 CrossRefPubMed
20.
Zurück zum Zitat Bednar DA, Grandwilewski W (1992) Complications of forearm-plate removal. Can J Surg 35(4):428–431PubMed Bednar DA, Grandwilewski W (1992) Complications of forearm-plate removal. Can J Surg 35(4):428–431PubMed
21.
Zurück zum Zitat Townend M, Parker P (2005) Metalwork removal in potential army recruits. Evidence-based changes to entry criteria. J R Army Med Corps 151(1):2–4CrossRefPubMed Townend M, Parker P (2005) Metalwork removal in potential army recruits. Evidence-based changes to entry criteria. J R Army Med Corps 151(1):2–4CrossRefPubMed
23.
Zurück zum Zitat Langkamer VG, Ackroyd CE (1990) Removal of forearm plates. A review of the complications. J Bone Joint Surg (Br) 72(4):601–604CrossRef Langkamer VG, Ackroyd CE (1990) Removal of forearm plates. A review of the complications. J Bone Joint Surg (Br) 72(4):601–604CrossRef
Metadaten
Titel
Complications during removal of conventional versus locked compression plates: is there a difference?
verfasst von
Hanjo Neumann
Anne Stadler
Hinrich Heuer
Marc Auerswald
Justus Gille
Arndt Peter Schulz
Benjamin Kienast
Publikationsdatum
24.12.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 8/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3352-7

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