Difficulties in removal of the titanium locking plate in Japan

Maehara, Takashi; Moritani, Shirou; Ikuma, Hisanori; Shinohara, Kensuke; Yokoyama, Yoshiki

doi:10.1016/j.injury.2013.01.042

Cited by 11 publications

(10 citation statements)

References 8 publications

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“…This suggests that changes could be made to improve the fixation system or to slow down the rehabilitation program to avoid screw breakage. Maehara et al 26 suggested that surgeons should be concerned about plate removal, and patients should be well-informed about the possibility of difficulty removing locking screws.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Complications During and After Medial Open-Wedge High Tibial Osteotomy Using a Locking Plate: A 3- to 7-Year Follow-up Study

Yabuuchi

Kondo

Onodera

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Outcomes and complications at mid- or long-term follow-up after medial open-wedge high tibial osteotomy (MOWHTO) with the TomoFix locking plate have not been fully evaluated. Purpose: To evaluate the complications and midterm clinical outcomes after MOWHTO using a TomoFix. Study Design: Case series; Level of evidence, 4. Methods: Enrolled in this study were 80 patients (85 knees) who underwent MOWHTO with the TomoFix locking plate between 2009 and 2013. There were 66 women and 14 men, with a mean age of 61.5 years at the time of surgery. The diagnosis was medial osteoarthritis in 76 knees and spontaneous osteonecrosis of the knee in 9 knees. Metal removal and second-look arthroscopy were performed in all cases. Clinical and radiological examinations were performed at final follow-up after surgery (mean, 4.5 years). Results: The mean Japanese Orthopaedic Association score and Knee injury and Osteoarthritis Outcome Score improved significantly from pre- to postoperatively ( P < .0001). The weightbearing line percentage shifted to pass through a point 67.7% lateral from the medial edge of the tibial plateau. The Caton-Deschamps index changed significantly from 0.88 to 0.66 at final follow-up ( P < .0001). The mean posterior tibial slope changed significantly from 8.9° to 11.9° at final follow-up ( P < .0001). Limb length was significantly increased after MOWHTO (10.3 mm; P < .0001). During plate removal, 14 locking screws were found to be broken in 9 knees (10.6%). The articular cartilage grade of the patellofemoral joint was significantly higher in the second arthroscopy than in the first arthroscopy ( P < .0001). The cumulative rate of all complications was 41.2%, with major complications (ie, those requiring additional or extended treatment) in 24.7%. Conclusion: Postoperative outcome scores indicated significant improvement after MOWHTO, although the cumulative rate of all complications was 41.2% and the rate of major complications was 24.7%. These results indicate that MOWHTO with the TomoFix is a technically demanding procedure. Careful preoperative planning and meticulous surgical technique are needed to decrease the incidence of complications associated with MOWHTO.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Complications During and After Medial Open-Wedge High Tibial Osteotomy Using a Locking Plate: A 3- to 7-Year Follow-up Study

Yabuuchi

Kondo

Onodera

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…Commonly used materials for internal fixation are bone plate, metal screw, intramedullary nail, steel nail and so on, which can fix the broken bone and have a better ability to maintain the normal physiological shape of the broken bone to heal (Boero Baroncelli et al 2012). However, the removal of these internal fixation materials has a high risk, such as slow callus formation at the bone plate joint or insufficient toughness of the new bone at the broken end (Arora et al 2007;Maehara et al 2013). Some medical diseases such as diabetes and cardiovascular diseases lead to osteoporosis and increase the risk of secondary fractures when the material is removed (Majumdar et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Internal Fixation Treatment of Multiple Fractures in a Dog

Chen¹,

Zhang²,

Wu³

et al. 2021

Agrobiol. Records

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In order to learn the diagnosis and treatment of canine fractures, we treated a stray dog in a traffic accident. We observed and recorded the treatment process in detail with the purpose of providing reference for the treatment of fractures in dogs. The doctors conducted general examination, X-ray and a complete blood count (CBC) on the dog at a pet hospital at Nanchang, Jiangxi, China, and then immediately performed surgery on the site of the severe fractures. Intramedullary nail and bone plate, and intramedullary nail and steel wire were respectively used for internal fixation of transverse fracture of femur of left hind-limb and oblique fracture of tibia of right hind-limb. Subsequently, suitable splint was used for external fixation, and the rest of the fractures healed on their own. After three months of postoperative nursing and massage, the internal fixation material was removed. The results showed that the dog had a good recovery. This paper has provided case study and a clinical practical reference for the diagnosis and treatment of complex multiple fractures.

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“…Moreover, only a few reports have focused on the difficulties encountered in the removal of locking head screws. 7,9,10 A study by Raja et al 11 showed that the removal difficulty rate was 47% for locking plates. Likewise, Sanderson et al 12 reported a 21% complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…5 Although difficulty in removing titanium locking plates is an uncommon problem, it can cause significant morbidities, such as fracture, retained implant, or prolonged hospitalization time. 6,7 Furthermore, there is a lack of literature describing the detailed causes and risk factors for difficulties in the removal of PFLPs in CP. The purpose of this study is to report the difficulties and risk factors of titanium PFLPs removal in CP.…”

mentioning

confidence: 99%