MANUFACTURE AND CLINICAL APPLICATION OF MEDICAL METAL DEBRIS ADSORPTION APPARATUS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YINQingwei , ZHANGHaibin

Department of Orthopaedics, Tianjin Dongli Hospital, Tianjin, 300203, P. R. China;

Corresponding author：

YINQingwei, Email: yqw1233068@sina.com

Keywords：

Medical metal debris adsorption apparatus; Locking screw; Slipping screw

DOI：

10.7507/1002-1892.20140265

Video：

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Objective To introduce a medical metal debris adsorption apparatus and to discuss the application value in removal of locking plate internal fixation. Methods Between January 2011 and May 2013, 83 cases underwent removal of locking plate fixation. There were 44 males and 39 females, aged 21-59 years (mean, 35.4 years). The time from the first operation to internal fixation removal was 16-40 months (mean, 22.6 months). Thirty-two screws of 9 patients were removed difficultly due to slide fastener. The screws were removed eventually after plates and screws were separated by grinding locking screw with manganese steel drill. In the process of grinding, the medical metal debris adsorption apparatus was used in 16 screws of 4 patients (group A), and was not used in 16 screws of 5 patients (group B). The operation time, removal time of single slipping screw, intraoperative blood loss, and the score of metal debris residues were compared between 2 groups. And the postoperative complications were recorded. Results A total of 658 screws were removed, and 32 slipping screws were found, accounting for 4.86%. The lock screw slipping rates of 3.5 mm and 4.5 or 5.0 mm respectively were 6.53% and 2.31%; and the lock screw slip ping rates of internal fixation time < 2 years and > 2 years respectively were 3.21% and 6.08%. The operation time, removal time of single slipping screw, intraoperative blood loss, and the score of metal debris residues of group A were significantly lower than those of group B (P < 0.05). Re-fracture (1 case) and incision infection (1 case) occurred in group B, and no complication was observed in group A. The cases of 2 groups were followed up 8-35 months (mean, 23.4 months). No heterotopic ossification occurred in both groups during the follow-up. Conclusion The medical metal debris adsorption apparatus can significantly shorten the operation time, reduce the residual metal debris and surgical bleeding when removing the slipping screws in removal of locking plate internal fixation.

Citation： YINQingwei, ZHANGHaibin. MANUFACTURE AND CLINICAL APPLICATION OF MEDICAL METAL DEBRIS ADSORPTION APPARATUS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1221-1224. doi: 10.7507/1002-1892.20140265 Copy

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3.	王大勇, 娄丽艳, 刘常胜, 等.内固定螺钉取出困难的应对方法及研究.实用骨科杂志, 2010, 16(8):633-634, 640.
4.	Ehlinger M, Adam P, Simon P, et al.Technical difficulties in hardware removal in titanium compression plates with locking screws.Orthop Traumatol Surg Res, 2009, 95(5):373-376.
5.	Smith WR, Ziran BH, Anglen JO, et al.Locking plates:tips and tricks.J Bone Joint Surg (Am), 2007, 89(10):2298-2307.
6.	王宏川, 庞贵根, 曾宪铁, 等.微创内固定系统取出术的困难及处理.中华创伤骨科杂志, 2009, 11(3):295-296.
7.	杨震龙, 马梦昆, 解京明.螺钉断钉及钉帽打滑时螺钉的取出方法.中国骨与关节损伤杂志, 2010, 25(4):376.
8.	秦晓平, 曹阳, 郭新辉, 等.钉帽单开槽在螺钉取出困难中的应用.临床骨科杂志, 2011, 14(5):504.
9.	[9马方.骨折内固定术后内固定物取出困难原因及对策.中国实用医药, 2011, 6(19):97-98.
10.	薛峰, 陈兵乾, 盛晓文, 等.MIPPO技术治疗四肢骨折.临床骨科杂志, 2009, 12(2):207-208.
11.	Bae JH, Oh JK, Oh CW, et al.Technical difficulties of removal of locking screw after locking compression plating.Arch Orthop Trauma Surg, 2009, 129(1):91-95.
12.	Hanson B, van der Weaken C, Stengel D.Surgeons' beliefs and perceptions about removal of orthopedic implants.BMC Musculoskelet Disord, 2008, 9:73.
13.	周健, 王天兵.内固定螺钉取出困难的原因及对策.解剖与临床, 2011, 16(2):171-173.

1. Charalambous CP, Siddique I, Valluripalli K, et al.Proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures.Arch Orthop Trauma Surg, 2007, 127(3):205-210.
2. Jamil W, Allami M, Choudhury MZ, et al.Do orthopaedic surgeons need a policy on the removal of metal work? A descriptive national survey of practicing surgeons in the United Kingdom.Injury, 2008, 39(3):362-367.
3. 王大勇, 娄丽艳, 刘常胜, 等.内固定螺钉取出困难的应对方法及研究.实用骨科杂志, 2010, 16(8):633-634, 640.
4. Ehlinger M, Adam P, Simon P, et al.Technical difficulties in hardware removal in titanium compression plates with locking screws.Orthop Traumatol Surg Res, 2009, 95(5):373-376.
5. Smith WR, Ziran BH, Anglen JO, et al.Locking plates:tips and tricks.J Bone Joint Surg (Am), 2007, 89(10):2298-2307.
6. 王宏川, 庞贵根, 曾宪铁, 等.微创内固定系统取出术的困难及处理.中华创伤骨科杂志, 2009, 11(3):295-296.
7. 杨震龙, 马梦昆, 解京明.螺钉断钉及钉帽打滑时螺钉的取出方法.中国骨与关节损伤杂志, 2010, 25(4):376.
8. 秦晓平, 曹阳, 郭新辉, 等.钉帽单开槽在螺钉取出困难中的应用.临床骨科杂志, 2011, 14(5):504.
9. [9马方.骨折内固定术后内固定物取出困难原因及对策.中国实用医药, 2011, 6(19):97-98.
10. 薛峰, 陈兵乾, 盛晓文, 等.MIPPO技术治疗四肢骨折.临床骨科杂志, 2009, 12(2):207-208.
11. Bae JH, Oh JK, Oh CW, et al.Technical difficulties of removal of locking screw after locking compression plating.Arch Orthop Trauma Surg, 2009, 129(1):91-95.
12. Hanson B, van der Weaken C, Stengel D.Surgeons' beliefs and perceptions about removal of orthopedic implants.BMC Musculoskelet Disord, 2008, 9:73.
13. 周健, 王天兵.内固定螺钉取出困难的原因及对策.解剖与临床, 2011, 16(2):171-173.

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MANUFACTURE AND CLINICAL APPLICATION OF MEDICAL METAL DEBRIS ADSORPTION APPARATUS

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