Technical difficulties in hardware removal in titanium compression plates with locking screws.
Locking Compression Plates (LCPs) have been introduced in the last decade. Clinicians have the impression that hardware removal of LCPs are more difficult and associated with more complications than conventional (non-locking) plates. Therefore, this study compares the complication rates of Locking Compression Plate (LCP) removal and conventional non-locking plate removal. Patients who underwent open reduction and internal fixation and subsequent hardware removal at the Department of Trauma Surgery at our Level 1 Trauma Centre between 1993 and 2007 were included through the hospital’s information system. The primary outcome measure was the occurrence of complications during implant removal. A total of 210 patients were included. The females were significantly older than the males [median age, 51.5 vs. 42.6 years (p < 0.001)]. The median operation time of LCP removal was significantly longer than the operation time of non-locking plate removal (72 vs. 54 min, p < 0.001). In the total study population, complications during implant removal occurred in 25 patients (11.9%). The complication rate of conventional non-locking plate removal was 2.5%. The complication rate of LCP removal was significantly higher (17.7%, p = 0.001). LCP removal is associated with significantly more complications than conventional non-locking plate removal. The indication for removal of locking compression should be made cautiously, and surgical instruments for LCP removal should be optimized.