Loose Jigs – A rare occurrence of misplaced screws

1. 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

2. 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

3. Case • 81 Female • PMH - Nil Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

4. 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

5. Post operative radiographs Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

6. Post operative radiographs • Proximal migration of the IM Nail Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

7. 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

8. Post operative radiographs • Loosening of Endcap Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

9. Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012 Proximal locking screws were posterior to the intramedullary nail

10. Revision Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012

11. 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

12. 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

13. 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

14. Any Questions? Loose jigs – A rare occurrence of misplaced screws Ankit Desai et al. 2012