Kaiser Philip B, Watkins Ian, Riedel Matthew D, Cronin Patrick, Briceno Jorge, Kwon John Y
Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts (PBK, IW, MDR).
Beth Israel Deaconess Medical Center, Boston, Massachusetts (JB, JYK).
Foot Ankle Spec. 2019 Feb;12(1):79-97. doi: 10.1177/1938640018791015. Epub 2018 Aug 22.
Orthopaedic surgery frequently requires the use of metal plate and screw constructs for osteosynthesis. These constructs may be subsequently removed for a variety of indications. In the lower extremity in particular, implants (ie, hardware) can lead to prominence and pain secondary to a thin soft-tissue envelope with little subcutaneous tissue. Often, removal is performed without knowledge of the exact type of screw head configuration and/or size, which can make removal technically challenging. The purpose of this study is to consolidate screw head sizes and configurations from commonly utilized orthopaedic foot and ankle implant manufacturers matched against 2 commonly used universal implant removal sets to aid in the expeditious removal of hardware.
Orthopaedic manufacturers of foot and ankle-specific implants were included based on market share. Publicly available information on screw size, head configuration, and driver size was collected and recorded. This information was cross-referenced against the drivers available in 2 commonly utilized universal implant removal sets.
Seven foot and ankle implant manufacturers were included. The data were compiled in table format according to manufacturer and subcategorized by noncannulated screws, cannulated screws, and locking screws.
Many factors affect the success of hardware removal, and it is imperative that the surgeon knows which drivers are compatible with the implanted hardware. The expanding magnitude and diversity of orthopaedic implants makes removal of hardware more challenging. A guide of compatible drivers for various screw types helps expedite this procedure.
Level V.
骨科手术经常需要使用金属板和螺钉结构进行骨接合。这些结构随后可能因各种指征而被取出。特别是在下肢，由于软组织包膜薄且皮下组织少，植入物（即硬件）可能导致突出和疼痛。通常，在不知道螺钉头部的确切形状和/或尺寸的情况下进行取出，这可能使取出在技术上具有挑战性。本研究的目的是汇总常用的足踝植入物制造商的螺钉头部尺寸和形状，并与2种常用的通用植入物取出套件进行匹配，以帮助快速取出硬件。
根据市场份额纳入足踝特定植入物的骨科制造商。收集并记录有关螺钉尺寸、头部形状和螺丝刀尺寸的公开信息。将这些信息与2种常用的通用植入物取出套件中的螺丝刀进行交叉参考。
纳入了7家足踝植入物制造商。数据以表格形式按制造商汇编，并按非空心螺钉、空心螺钉和锁定螺钉进行分类。
许多因素影响硬件取出的成功率，外科医生必须知道哪些螺丝刀与植入的硬件兼容。骨科植入物数量的增加和种类的多样化使得硬件取出更具挑战性。一份各种螺钉类型兼容螺丝刀的指南有助于加快这一过程。
V级。
