Cronin Patrick K, Watkins Ian T, Riedel Matthew, Kaiser Philip B, Kwon John Y
Harvard University, Combined Orthopaedic Residency Program, Boston, MA, USA.
Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA.
Arch Bone Jt Surg. 2020 Jan;8(1):99-111. doi: 10.22038/abjs.2019.36525.1962.
Orthopedic implant removal is a commonly performed procedure. While implant removal can be associated with improved symptoms, risks of the surgery are notable. Stripped screws, broken and retained hardware, and morbidity associated with soft tissue compromise during difficult removal are all common. Familiarity with the instruments is critical to procedure success. The purpose of this study is to assist removal of unfamiliar screws in upper extremity surgery by offering a reference for screw and driver compatibility across manufacturers. Inclusion of device manufacturers was determined by market share. Screw size, drive configuration, and screw removal system compatibility data was collected and recorded. Screw, guide-wire, and screwdriver compatibility was assessed and compared to two commonly utilized universal implant-removal sets. Eight upper extremity implant vendors were included. The data was compiled in table format according to manufacturer and sub-categorized to facilitate screw identification according to radiographically identifiable characteristics. The diversity of orthopaedic implants in upper extremity surgery requires careful preoperative planning to identify the appropriate equipment for implant removal. The goal of this work is to provide a centralized reference of commonly implanted screws, guide-wires, and drivers for the upper extremity to facilitate removal.
骨科植入物取出是一种常见的手术操作。虽然取出植入物可能会改善症状，但手术风险也较为显著。螺丝滑丝、硬件折断和残留以及在困难取出过程中与软组织受损相关的发病率都很常见。熟悉器械对于手术成功至关重要。本研究的目的是通过提供各制造商螺丝与螺丝刀兼容性的参考，协助上肢手术中不熟悉的螺丝取出。设备制造商的纳入是根据市场份额确定的。收集并记录了螺丝尺寸、驱动配置和螺丝取出系统兼容性数据。评估了螺丝、导丝和螺丝刀的兼容性，并与两种常用的通用植入物取出套件进行了比较。纳入了八家上肢植入物供应商。数据按照制造商以表格形式汇编，并进行了细分，以便根据影像学可识别特征方便地识别螺丝。上肢手术中骨科植入物的多样性需要仔细的术前规划，以确定取出植入物的合适设备。这项工作的目标是提供上肢常用植入螺丝、导丝和螺丝刀的集中参考，以方便取出。
