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

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, 婁麗艷, 劉常勝, 等.內固定螺釘取出困難的應對方法及研究.實用骨科雜志, 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, 龐貴根, 曾憲鐵, 等.微創內固定系統取出術的困難及處理.中華創傷骨科雜志, 2009, 11(3):295-296.
7.	楊震龍, 馬夢昆, 解京明.螺釘斷釘及釘帽打滑時螺釘的取出方法.中國骨與關節損傷雜志, 2010, 25(4):376.
8.	秦曉平, 曹陽, 郭新輝, 等.釘帽單開槽在螺釘取出困難中的應用.臨床骨科雜志, 2011, 14(5):504.
9.	[9馬方.骨折內固定術后內固定物取出困難原因及對策.中國實用醫藥, 2011, 6(19):97-98.
10.	薛峰, 陳兵乾, 盛曉文, 等.MIPPO技術治療四肢骨折.臨床骨科雜志, 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.內固定螺釘取出困難的原因及對策.解剖與臨床, 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, 婁麗艷, 劉常勝, 等.內固定螺釘取出困難的應對方法及研究.實用骨科雜志, 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, 龐貴根, 曾憲鐵, 等.微創內固定系統取出術的困難及處理.中華創傷骨科雜志, 2009, 11(3):295-296.
7. 楊震龍, 馬夢昆, 解京明.螺釘斷釘及釘帽打滑時螺釘的取出方法.中國骨與關節損傷雜志, 2010, 25(4):376.
8. 秦曉平, 曹陽, 郭新輝, 等.釘帽單開槽在螺釘取出困難中的應用.臨床骨科雜志, 2011, 14(5):504.
9. [9馬方.骨折內固定術后內固定物取出困難原因及對策.中國實用醫藥, 2011, 6(19):97-98.
10. 薛峰, 陳兵乾, 盛曉文, 等.MIPPO技術治療四肢骨折.臨床骨科雜志, 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.內固定螺釘取出困難的原因及對策.解剖與臨床, 2011, 16(2):171-173.

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MANUFACTURE AND CLINICAL APPLICATION OF MEDICAL METAL DEBRIS ADSORPTION APPARATUS

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