Abstract
The purpose of this study was to present a surgical technique for taking out universal screw and nail caps which were difficult to removed. We used a variety of industrial hex wrenches, dental drills, and other equipment to take out internal hex nuts with different specifications (32 pieces) and universal screws (15 pieces) in 28 patients. A total of 32 nuts were taken out, 3 of which were polished by the industrial drill. A total of 17 were spun by hand, 2 were spun by locking pliers, 10 were turned by “I” type screwdriver, and 3 were turned by bone blade. A total of 15 screws were taken out, 9 of which were removed with a wrench and the other 6 by means of locking pliers after re‐fixing with a truncated titanium rod. The novel technique is simple and provides a solution following failure of a supporting device.
Highlights
The pedicle screw internal fixation system is widely used for the treatment of spinal fractures and degenerative instability[1,2,3]
The extension of the internal fixation device increases the risk of breakage from screw fatigue[7]
There are reports on the removal methods of broken screws, and each method has its own advantages and disadvantages[9,10,11], but there are no reports in the literature on removal methods in circumstances such as the screw cap slipping, deformation, and damage
Summary
The pedicle screw internal fixation system is widely used for the treatment of spinal fractures and degenerative instability[1,2,3]. There are many potential complications, such as pedicle screw breakage, loosening, and deformation[4]. Pedicle screw loosening or breakage is a common complication, and depends on the strength of the interface between the internal fixation device and the bone[5,6]. The extension of the internal fixation device increases the risk of breakage from screw fatigue[7]. Due to the large number of manufacturers, the designs of pedicle screw tails and the nut specifications vary[8]. It is often difficult to find suitable equipment to remove them, and some patients cannot provide details of manufacturers of the screws. We use a variety of industrial hex wrenches, dental drills, and other equipment to take out imported and domestic internal hex nuts (32 pieces) and universal screws (15 pieces) with various specifications.
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