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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

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

slide3
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

slide9

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

slide11
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

slide12
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

slide13
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

slide14
Any Questions?

Loose jigs – A rare occurrence of misplaced screws

Ankit Desai et al. 2012

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