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- Apr 11, 2008
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I am looking for practice suggestions / standard of care for orthopedic hardware removal.
At my community hospital we have several orthopedic surgeons who remove spinal hardware frequently and about 90 percent of the time it goes smoothly, sometimes they have to break a screw shaft or a rod, but that is somewhat rare.
The spinal hardware that comes out is pretty consistent and there is little variation may times, usually rods / screws / sometimes a clamp / and bolt type washer screws.
The other day, we had a hardware removal from a lumbar spine where there was no corresponding (hex / bit) to remove certain screws and the surgeon modified equipment to get it out and broke the screw heads. In my non orthopedic surgeon view, these specific screws were not star shaped where the bit goes like many I see, but seemed older with more of a square hole in the screw head for the drill bit. One broke, but all the pieces were removed.
Admin / management got bent out of shape because many surgical trays were opened looking for one. I said most universal screw removal kits usually have all these bits, but apparently not. I said to my eye (and even compared it to screws from other surgeries that we had) these particular screws seem much of and older brand I haven't seen before.
Was looking for opinions and commentary. I am sorry for the butchering of these descriptions, but I am a pathologist trying to help the orthopedic surgeon out.
Thanks.
At my community hospital we have several orthopedic surgeons who remove spinal hardware frequently and about 90 percent of the time it goes smoothly, sometimes they have to break a screw shaft or a rod, but that is somewhat rare.
The spinal hardware that comes out is pretty consistent and there is little variation may times, usually rods / screws / sometimes a clamp / and bolt type washer screws.
The other day, we had a hardware removal from a lumbar spine where there was no corresponding (hex / bit) to remove certain screws and the surgeon modified equipment to get it out and broke the screw heads. In my non orthopedic surgeon view, these specific screws were not star shaped where the bit goes like many I see, but seemed older with more of a square hole in the screw head for the drill bit. One broke, but all the pieces were removed.
Admin / management got bent out of shape because many surgical trays were opened looking for one. I said most universal screw removal kits usually have all these bits, but apparently not. I said to my eye (and even compared it to screws from other surgeries that we had) these particular screws seem much of and older brand I haven't seen before.
Was looking for opinions and commentary. I am sorry for the butchering of these descriptions, but I am a pathologist trying to help the orthopedic surgeon out.
Thanks.
