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Case Reports
. 2019 Mar-Apr;10(2):422-426.
doi: 10.1016/j.jcot.2018.05.015. Epub 2018 May 24.

Use of high-speed burr and water-based lubricant in the partial removal of surgical plates: A technique Guide

Jon E Hammarstedt  1 , Grigory E Gershkovich  2 , Daniel P Mass  2
Affiliations
Case Reports

Use of high-speed burr and water-based lubricant in the partial removal of surgical plates: A technique Guide

Jon E Hammarstedt et al. J Clin Orthop Trauma. 2019 Mar-Apr.

Erratum in

Abstract

Implant removal comprises 5% of all orthopaedic surgery procedures performed annually. Surgical indications range from implant failure, infection, non-union, and symptomatic hardware. Intra-operatively, surgeons need to prepare for complications including bony overgrowth, cold-welding, broken screws, and stripped screw heads. Large anatomic dissections required for complete hardware removal place the patient at increased risk of complications due to increased operating time and larger dissections. The authors present a safe and effective technique for the partial removal of surgical implants. The technique utilizes a high-speed burr to cut surgical plates, minimizing the total dissection and operative time. Sterile surgical laps covered in water-based lubricant capture metal debris to reduce tissue contamination as well as surgeon exposure to metal particles.

Keywords: Hardware removal; High speed burr; Revision surgery; Surgical hardware.

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Figures

Fig. 1
Fig. 1
Exposed surgical plate surrounded by sterile surgical lap coated in water based lubricant.
Fig. 2
Fig. 2
Illustration depicting proper placement of high-speed burr on surgical plate in order to minimize surface area for cutting.
Fig. 3
Fig. 3
Completion of cutting through one side of the surgical plate by the use of high-speed burr.
Fig. 4
Fig. 4
Successful completion of partial urgical plate with demonstration of metal debris capture by sterile surgical laps covered with sterile water-based lubricant.
Fig. 5
Fig. 5
Preoperative radiograph of a 38-year-old male with limited range of motion and pain demonstrating broken and prominent hardware in the posterior and lateral aspect of the distal humerus.
Fig. 6
Fig. 6
Postoperative radiographs of 38-year-old patient undergoing hardware removal, kashiwagi-outerbridge, joint capsule debridement, internal joint stabilizer, and radial head excision. Intra-operatively the decision was made to remove only the symptomatic portion of the humeral plate to reduce anatomic dissection.
Fig. 7
Fig. 7
Preoperative radiograph of an 80-year-old female with refractory pain demonstrating midshaft humeral non-union and broken hardware.
Fig. 8
Fig. 8
Postoperative radiographs of 80-year-old female after open reduction internal fixation and reverse total shoulder arthroplasty. Intra-operatively the decision was made to remove only the necessary portion of the humeral plate to reduce anatomic dissection.
See this image and copyright information in PMC

References

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