Removal of locked volar plates after distal radius fractures.

PURPOSE: We present our experience with removal of locked volar distal radius plates and screws and note the indications for removal, types of plates removed, completeness of hardware removal, and complications occurring during plate removal.

METHODS: We reviewed all distal radial volar locking plates removed at our institution from 2004 to 2009. A total of 28 patients operated on by 5 hand surgeons were identified. We gathered information regarding the incidence of successful removal of hardware and operative findings in cases of difficult removal of hardware.

RESULTS: A total of 28 patients (16 women, 12 men) underwent removal of locked volar distal radius plates from 2004 to 2009. The mean length of implantation was 63 weeks (range, 3-223 wk). Reasons for removal of hardware included tenosynovitis, tendon rupture, pain, and prominent or intra-articular hardware. Of 28 cases of locked volar plate removal, 2 had complications. In the first case, a screw was cross-threaded in an earlier generation DVR Hand Innovations plate implanted in 2003. The plate and screw were removed by rotating them out as 1 unit. In the second case, in which the current generation DVR Hand Innovations plate was implanted in 2007, the recess in the screw head had been stripped on insertion. The plate was cut and the remaining fragment of plate and screw were removed together. Despite these difficulties, hardware was successfully removed completely in 28 patients.

CONCLUSIONS: This case series highlights the result that all removals of locked volar plates were successful. There were 2 complications, and strategies for removal are described.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.