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HOME > J Musculoskelet Trauma > Volume 24(2); 2011 > Article
Original Article
Failure of Removal of Stripped Locking Screw after Locking Compression Plating
Sung-Jin Kim, M.D., Kyung-Jae Lee, M.D., Ph.D.
Journal of the Korean Fracture Society 2011;24(2):169-173.
DOI: https://doi.org/10.12671/jkfs.2011.24.2.169
Published online: April 13, 2011

Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, Korea.

*Department of Emergency, School of Medicine, Keimyung University, Daegu, Korea.

Address reprint requests to: Kyung-Jae Lee, M.D., Ph.D. Department of Orthopedic Surgery, School of Medicine, Keimyung University, 194, Dongsan-dong, Jung-gu, Daegu 700-712, Korea. Tel: 82-53-250-7729, Fax: 82-53-250-7205, oslee@dsmc.or.kr
• Received: March 9, 2010   • Revised: July 11, 2010   • Accepted: March 30, 2011

Copyright © 2011 The Korean Fracture Society

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  • Purpose
    The purpose of this study was to evaluate the incidence and possible causes of stripped locking screws that make difficult to remove the locking compression plate. We also tried to find the useful methods to remove the stripped locking screws.
  • Materials and Methods
    Between May 2005 and January 2009, 84 patients who underwent operations for removal of locking compression plate were included in this study. We removed 298 3.5-mm locking screws and 289 5.0-mm locking screws in these patients. We retrospectively investigated the incidence and possible causes of stripped locking screws and evaluated the pros and cons of the methods that we have used to remove the stripped locking screws.
  • Results
    17 out of 298 3.5-mm locking screws (5.7%) and 2 out of 289 5.0-mm locking screws (0.7%) were encountered with difficulties by hexagonal driver during removal because of the stripping of the hexagonal recess. First we used the conical extraction screw for all the stripped locking screws and only 3 screws were removed successfully. We removed 3 screws by cutting the plate around the stripped locking screw and twisting the plate with the screw and we removed 1 screw by the use of hallow reamer after cutting the plate. Twelve screw shafts were left except grinding of screw head by metal-cutting burr. There was one iatrogenic re-fracture in whom we have used with hallow reamer.
  • Conclusion
    At the time of locking compression plate removal, difficulties of locking screw removal due to the stripping of the hexagonal recess should be expected and surgeon must prepare several methods to solve this problem.
  • Key words: Locking compression plate, Locking screw, Failure of removal
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Fig. 1
The conical extraction screw can be used for the removal of stripped locking screws at the first attempt.
jkfs-24-169-g001.jpg
Fig. 2
(A) and (B) Stripped locking screws can be removed by cutting the plate around the screw and twisting the plate with the screw. There are a lot of metal particles around the plate (black arrows).
jkfs-24-169-g002.jpg
Fig. 3
(A) Stripped locking screw was removed with the hallow reamer in patient who is 21-years old male. There is cortical defect where hallow reamer was used (white arrow).
(B) After one month after plate removal, re-fracture was developed without trauma.
jkfs-24-169-g003.jpg
Fig. 4
(A) 29-years old male who had distal humerus fracture was treated with small locking compression plate.
(B) After 24 months after initial operation, the plate was removed. There shows two remained locking screw shaft because of stripped locking screw head.
jkfs-24-169-g004.jpg
Fig. 5
(A) and (B) The targeting device can be locked in locking compression plate with wrong angle and it can causes wrong insertion angle of locking screws.
jkfs-24-169-g005.jpg
Table 1
Types of implant used in this study
jkfs-24-169-i001.jpg

LCP: Locking compression plate, PLT: Proximal lateral tibia, DMT: Distal medial tibia, LPH: Lateral proximal humerus, Number: Plate number.

Figure & Data

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    • An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report
      Won Ro Park, Jae Hoon Jang
      International Journal of Surgery Case Reports.2019; 57: 134.     CrossRef

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      Failure of Removal of Stripped Locking Screw after Locking Compression Plating
      J Korean Fract Soc. 2011;24(2):169-173.   Published online April 30, 2011
      DOI: https://doi.org/10.12671/jkfs.2011.24.2.169
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    Failure of Removal of Stripped Locking Screw after Locking Compression Plating
    Image Image Image Image Image
    Fig. 1 The conical extraction screw can be used for the removal of stripped locking screws at the first attempt.
    Fig. 2 (A) and (B) Stripped locking screws can be removed by cutting the plate around the screw and twisting the plate with the screw. There are a lot of metal particles around the plate (black arrows).
    Fig. 3 (A) Stripped locking screw was removed with the hallow reamer in patient who is 21-years old male. There is cortical defect where hallow reamer was used (white arrow). (B) After one month after plate removal, re-fracture was developed without trauma.
    Fig. 4 (A) 29-years old male who had distal humerus fracture was treated with small locking compression plate. (B) After 24 months after initial operation, the plate was removed. There shows two remained locking screw shaft because of stripped locking screw head.
    Fig. 5 (A) and (B) The targeting device can be locked in locking compression plate with wrong angle and it can causes wrong insertion angle of locking screws.

    Fig. 1

    Fig. 2

    Fig. 3

    Fig. 4

    Fig. 5

    Failure of Removal of Stripped Locking Screw after Locking Compression Plating

    Types of implant used in this study

    LCP: Locking compression plate, PLT: Proximal lateral tibia, DMT: Distal medial tibia, LPH: Lateral proximal humerus, Number: Plate number.
    Table 1 Types of implant used in this study

    LCP: Locking compression plate, PLT: Proximal lateral tibia, DMT: Distal medial tibia, LPH: Lateral proximal humerus, Number: Plate number.

    Table 1

    J Musculoskelet Trauma : Journal of Musculoskeletal Trauma
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