title: Locking Compression Plates are more difficult to remove than conventional non-locking plates.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Academic Medical Centre, Department of Trauma Surgery, University of Amsterdam, G4, Post box 22660, 1105 AZ, Amsterdam, The Netherlands. G.D.Musters@amc.nl.
authors.forename: G D
authors.initials: GD
authors.lastname: Musters
authors.affiliation: Academic Medical Centre, Department of Trauma Surgery, University of Amsterdam, G4, Post box 22660, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Boele van Hensbroek
authors.affiliation: Academic Medical Centre, Department of Trauma Surgery, University of Amsterdam, G4, Post box 22660, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: K J
authors.initials: KJ
authors.lastname: Ponsen
authors.affiliation: Academic Medical Centre, Department of Trauma Surgery, University of Amsterdam, G4, Post box 22660, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J S K
authors.initials: JS
authors.lastname: Luitse
authors.affiliation: Academic Medical Centre, Department of Trauma Surgery, University of Amsterdam, G4, Post box 22660, 1105 AZ, Amsterdam, The Netherlands. j.c.goslings@amc.nl.
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
keywords: Complications; Conventional plates; Hardware removal; LCP; Locking compression plates
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