Late fracture associated with retained internal fixation

Bransby-Zachary, Marc; MacDonald, D. A.; Singh, Ishwar; Newman, Raymond J.

doi:10.1302/0301-620x.71b3.2722960

Cited by 14 publications

(2 citation statements)

References 1 publication

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“…Local osteopenia, stress fractures, metal toxicity, corrosion, and malignancy are reportedly associated with retention of metal implants. [6][7][8] In addition to the typical reasons for difficulty with implant removal, such as stripping of the screw head recess, it can be considerably difficult to remove a screw when the screw and the screw hole of the intramedullary nail or the locking plate have become crossthreaded. 1,[9][10][11][12] Further difficulty may be encountered when there is cortical bone ingrowth at the end flutes of the screw.…”

Section: Discussionmentioning

confidence: 99%

New Technique for Removal of Screws With Damaged Heads

Iwata¹,

Nozawa²,

Maeda³

et al. 2017

Orthopedics

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Removal of orthopedic implants may sometimes be difficult because of ongrowth of new bone. Titanium screws can become encased or stripped during the process of initial open reduction and internal fixation or at the time of hardware removal. Difficulty in removing screws from a locking plate is particularly well-known. Two patients with tibial and femoral diaphyseal fractures were treated using a locking plate or an intramedullary nail. However, after fracture healing, it was difficult to remove the locking screw or reconstruction screws because of damage to the heads. The stripped reconstruction screw was successfully removed employing the authors' so-called parallel planes technique. In this method, a high-speed diamond-tipped burr is applied to opposite sides of the screw head to form 2 parallel faces located slightly away from the recess of the screw head. The 2 faces can then be grasped solidly with locking pliers, allowing removal of the implant by unscrewing it with a gentle upward pulling action. The locking plate was cut from the plate edge to the edge of the screw hole. While making these radial cuts in the plates, the authors were careful not to extend the blade into the screw head. After removal of the locking plate from the screw, the authors were able to extract the jammed screw uneventfully using this technique. This technique can be performed without difficulty and does not require a special device. It is a useful option for extraction of damaged screws. [Orthopedics. 2017; 40(5):e911-e914.].

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Section: Discussionmentioning

confidence: 99%

New Technique for Removal of Screws With Damaged Heads

Iwata¹,

Nozawa²,

Maeda³

et al. 2017

Orthopedics

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“…An implant-related fracture is a recognised complication of a retained plate, 1,11 which acts as a stress riser. 12 However, the true incidence of such fractures is not known. We observed a 7.3% risk of an implant-related fracture during a ten year period; all fractures occurred within the first three post-operative years.…”

Section: Discussionmentioning

confidence: 99%

Retention of forearm plates

Clement

Yousif

Duckworth

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Most surgeons favour removing forearm plates in children. There is, however, no long-term data regarding the complications of retaining a plate. We present a prospective case series of 82 paediatric patients who underwent plating of their forearm fracture over an eight-year period with a minimum follow-up of two years. The study institution does not routinely remove forearm plates. A total of 116 plates were used: 79 one-third tubular plates and 37 dynamic compression plates (DCP). There were 12 complications: six plates (7.3%) were removed for pain or stiffness and there were six (7.3%) implant-related fractures. Overall, survival of the plates was 85% at 10 years. Cox regression analysis identified radial plates (odds ratio (OR) 4.4, p = 0.03) and DCP fixation (OR 3.2, p = 0.02) to be independent risk factors of an implant-related fracture. In contrast ulnar plates were more likely to cause pain or irritation necessitating removal (OR 5.6, p = 0.04). The complications associated with retaining a plate are different, but do not occur more frequently than the complications following removal of a plate in children.

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Fractures of the Pediatric Foot and Ankle

Carpenter

Williams

2019

The Pediatric Foot and Ankle

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Late fracture associated with retained internal fixation

Cited by 14 publications

References 1 publication

New Technique for Removal of Screws With Damaged Heads

New Technique for Removal of Screws With Damaged Heads

Retention of forearm plates

Fractures of the Pediatric Foot and Ankle

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