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.

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Loose Jigs – A rare occurrence of misplaced screws

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Loose jigs a rare occurrence of misplaced screws

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

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


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


Background1

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

Post operative radiographs

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


Post operative radiographs1

Post operative radiographs

  • Proximal migration of the IM Nail

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


Post operative radiographs2

Post operative radiographs

  • Conversion of screws

  • Medialisation of screws from lateral cortex

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


Post operative radiographs3

Post operative radiographs

  • Loosening of Endcap

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


Loose jigs a rare occurrence of misplaced screws

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012

Proximal locking screws were posterior to the intramedullary nail


Revision

Revision

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


Loose jigs a rare occurrence of misplaced screws

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


Loose jigs a rare occurrence of misplaced screws

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


Loose jigs a rare occurrence of misplaced screws

Learning points

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012

Essential to check and re-check jig

Surgeons responsibility to ensure correct placement prior to closure –AP and lateral Image intensifier films

Discuss issues with company rep

- Single construct jig now to be introduced


Loose jigs a rare occurrence of misplaced screws

Any Questions?

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012


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