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A Novel Surgical Technique for Removing Buried Cannulated Screws Using a Guidewire and Countersink: A Report of Two Cases.

Chen Y, Giri KP, Pearce CJ - Open Orthop J (2015)

Bottom Line: The problem is further compounded when the initial screw was inserted percutaneously or via a minimally-invasive (MIS) technique.This technique is especially useful in removing cannulated screws which have been inserted using small stab incisions and MIS techniques initially.This technique can be applied to the removal of buried cannulated screws which are placed into any bone in the body.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Alexandra Hospital, Singapore.

ABSTRACT
Removal of metal implants is a common procedure that is performed for a variety of indications. However, problems such as a buried screw head may occasionally arise and render hardware removal difficult or even impossible. The problem is further compounded when the initial screw was inserted percutaneously or via a minimally-invasive (MIS) technique. In the present paper, we introduce a novel, minimally invasive technique to remove buried cannulated screws which obviates the need for excessive extension of the skin incision, surgical exploration, soft tissue dissection or excess bone removal, which surgeons may otherwise have to undertake to uncover the buried screw head. This technique is especially useful in removing cannulated screws which have been inserted using small stab incisions and MIS techniques initially. This technique can be applied to the removal of buried cannulated screws which are placed into any bone in the body.

No MeSH data available.


Related in: MedlinePlus

The fluoroscopy unit is adjusted until a perfect circle of thecannulated hole is clearly visible. An attempt is then made to insertthe cannulated guidewire into the cannulated hole underfluoroscopic guidance.
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Figure 5: The fluoroscopy unit is adjusted until a perfect circle of thecannulated hole is clearly visible. An attempt is then made to insertthe cannulated guidewire into the cannulated hole underfluoroscopic guidance.

Mentions: In the second case, a 24 year-old labourer had previously sustained an intra-articular calcaneal fracture following a fall from height 4 months earlier. This was again fixed using percutaneous cancellous screws (Fig. 4). Unfortunately, two K-wires were broken during the initial fixation and were left in situ. Following fracture union, the patient requested a removal of implants. The sinus tarsi screw removal was difficult due to buried screw head, but this was successfully salvaged using the present technique (Figs. 5-7).


A Novel Surgical Technique for Removing Buried Cannulated Screws Using a Guidewire and Countersink: A Report of Two Cases.

Chen Y, Giri KP, Pearce CJ - Open Orthop J (2015)

The fluoroscopy unit is adjusted until a perfect circle of thecannulated hole is clearly visible. An attempt is then made to insertthe cannulated guidewire into the cannulated hole underfluoroscopic guidance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493633&req=5

Figure 5: The fluoroscopy unit is adjusted until a perfect circle of thecannulated hole is clearly visible. An attempt is then made to insertthe cannulated guidewire into the cannulated hole underfluoroscopic guidance.
Mentions: In the second case, a 24 year-old labourer had previously sustained an intra-articular calcaneal fracture following a fall from height 4 months earlier. This was again fixed using percutaneous cancellous screws (Fig. 4). Unfortunately, two K-wires were broken during the initial fixation and were left in situ. Following fracture union, the patient requested a removal of implants. The sinus tarsi screw removal was difficult due to buried screw head, but this was successfully salvaged using the present technique (Figs. 5-7).

Bottom Line: The problem is further compounded when the initial screw was inserted percutaneously or via a minimally-invasive (MIS) technique.This technique is especially useful in removing cannulated screws which have been inserted using small stab incisions and MIS techniques initially.This technique can be applied to the removal of buried cannulated screws which are placed into any bone in the body.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Alexandra Hospital, Singapore.

ABSTRACT
Removal of metal implants is a common procedure that is performed for a variety of indications. However, problems such as a buried screw head may occasionally arise and render hardware removal difficult or even impossible. The problem is further compounded when the initial screw was inserted percutaneously or via a minimally-invasive (MIS) technique. In the present paper, we introduce a novel, minimally invasive technique to remove buried cannulated screws which obviates the need for excessive extension of the skin incision, surgical exploration, soft tissue dissection or excess bone removal, which surgeons may otherwise have to undertake to uncover the buried screw head. This technique is especially useful in removing cannulated screws which have been inserted using small stab incisions and MIS techniques initially. This technique can be applied to the removal of buried cannulated screws which are placed into any bone in the body.

No MeSH data available.


Related in: MedlinePlus