Easy and Inexpensive Technique for Removal of Round Headed, Jammed Locking Screws in Distal Tibial Interlocking Plate.

INTRODUCTION: The advent of locking plates has brought new problems in implant removal. Difficulty in removing screws from a locking plate is well-known. These difficulties include cold welding between the screw head and locking screw hole, stripping of the recess of the screw head for the screwdriver, and cross-threading between threads in the screw head and screw hole. However, there are cases in which removal is difficult. We describe a new technique for removing a round headed, jammed locking screws from a locking plate.

CASE REPORT: 55 years old male patient received a locking distal tibial plate along with distal fibular plate 3years back from UAE. Now patient came with complaint of non-healing ulcer over medial aspect of lower 1/3rd of right leg from past 1 year. Non operative management did not improve the symptoms. The patient consented to implant removal, with the express understanding that implant removal might be impossible because already one failed attempt had been performed at some other hospital six months back. We then decided to proceed with the new technique. The rest of the proximal screws were removed using a technique not previously described. We used stainless steel metal cutting blades that are used to cut door locks or pad locks to cut the remaining stripped headed screws.

CONCLUSION: This technique is very quick, easy to perform and inexpensive because the metal cutting blades which are used to cut the screws are very cheap. Yet it is very effective technique to remove the stripped headed or jammed locking screws. It is also very less destructive because of very less heat production during the procedure there is no problem of thermal necrosis to the bone or the surrounding soft tissue.