The locking caps were returned for evaluation.Three of the four caps had wear on the bottom that is consistent with wear during final tightening onto a rod.There was evidence on these three caps of wear in the drive feature also consistent with final tightening.The imaging provided was inconclusive about the caps, but rod migration could be seen.It was reported that the patient fell and heard a "pop".The patient is obese with high bmi of 46.3.With a high bmi and the typical force of a fall postoperatively, this is consistent with excessive force placed on the construct, which may have been a contributing factor; however, a cause of the reported issue could not be determined.
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