loose jigs – a rare occurrence of misplaced screws

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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

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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. - PowerPoint PPT Presentation

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Page 1: Loose Jigs  –  A  rare occurrence of misplaced screws

Loose Jigs – A rare occurrence of misplaced screws

Ankit Desai CT1S. 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

Page 2: Loose Jigs  –  A  rare occurrence of misplaced screws

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

Page 3: Loose Jigs  –  A  rare occurrence of misplaced screws

Case

• 81 Female• PMH - Nil

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 4: Loose Jigs  –  A  rare occurrence of misplaced screws

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

Page 5: Loose Jigs  –  A  rare occurrence of misplaced screws

Post operative radiographs

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 6: Loose Jigs  –  A  rare occurrence of misplaced screws

Post operative radiographs

1. Proximal migration of the IM Nail

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 7: Loose Jigs  –  A  rare occurrence of misplaced screws

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

Page 8: Loose Jigs  –  A  rare occurrence of misplaced screws

Post operative radiographs

1. Loosening of Endcap

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 9: Loose Jigs  –  A  rare occurrence of misplaced screws

Proximal locking screws were posterior to the intramedullary nail

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 10: Loose Jigs  –  A  rare occurrence of misplaced screws

Revision

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

Page 11: Loose Jigs  –  A  rare occurrence of misplaced screws

Discussion–Misplaced locking screws• Known problem?• Equipment error?

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

T2 Recon Nailing System. Operative Technique. Stryker. 2004

Page 12: Loose Jigs  –  A  rare occurrence of misplaced screws

Discussion

T2 Recon Nailing System. Operative Technique. Stryker. 2004

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

–Misplaced locking screws• Known problem?• Equipment error?

Page 13: Loose Jigs  –  A  rare occurrence of misplaced screws

Learning points1. Essential to check and re-check jig2. 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

Page 14: Loose Jigs  –  A  rare occurrence of misplaced screws

Any Questions?

Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012