Percutaneous plate fixation for peri-articular distal tibial fractures reduces the risk of complications such as non-union and infection when compared to traditional open fixation. To remove such plates whilst minimising soft tissue disruption, carefully open the old incisional scars, locate the plate and remove the screws. Using a simple punch, sequentially tap the plate from either side so as to free it from any bony adhesions. Remove the plate through a subcutaneous tunnel recreated with minimal soft tissue dissection and close all the wounds with nylon sutures. We have experienced no complications with this procedure but would recommend a pre-operative X-ray to confirm that the fracture has healed (Fig. 1).
Figure 1.
Pre-operative X-ray