Transcript Misplaced Intramedullary Nails – A rare occurrence

Loose Jigs –
A rare occurrence of misplaced screws
Ankit Desai CT1
S. Lidder, C. Dowd-O’Booth, A. D. Skyrme
Department of Trauma and Orthopaedics, Eastbourne District General Hospital, London, UK
KSS Prize Day – January 2012
University of Surrey, Guildford
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Background
• Hip Fractures are Common 75,000/year
• High Morbidity and Mortality
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Case
• 81 Female
• PMH - Nil
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Background
Intramedullary Nail
National Institute for Health and Clinical
Excellence (2011) Hip fracture: The management
of hip fracture in adults. [CG124]
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Post operative radiographs
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Post operative radiographs
1. Proximal
migration of the
IM Nail
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Post operative radiographs
1. Conversion of
screws
2. Medialisation of
screws from
lateral cortex
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Post operative radiographs
1. Loosening of
Endcap
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Proximal
locking screws
were posterior
to the
intramedullary
nail
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Revision
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Discussion
– Misplaced locking screws
• Known problem?
• Equipment error?
T2 Recon Nailing System. Operative
Technique. Stryker. 2004
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Discussion
– Misplaced locking screws
• Known problem?
• Equipment error?
T2 Recon Nailing System. Operative
Technique. Stryker. 2004
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Learning points
1. Essential to check and re-check jig
2. Surgeons responsibility to ensure correct placement prior
to closure –AP and lateral Image intensifier films
3. Discuss issues with company rep
- Single construct jig now to be introduced
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012
Any Questions?
Loose jigs – A rare occurrence of misplaced screws
Ankit Desai et al. 2012