Loose Jigs – A rare occurrence of misplaced screws
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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
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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
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Case
• 81 Female• PMH - Nil
Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012
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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
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Post operative radiographs
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Post operative radiographs
1. Proximal migration of the IM Nail
Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012
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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
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Post operative radiographs
1. Loosening of Endcap
Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012
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Proximal locking screws were posterior to the intramedullary nail
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Revision
Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012
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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
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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?
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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
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Any Questions?
Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012