Implant Removal Matrix for the Upper Extremity Orthopedic Surgeon

Abstract

Orthopedic implant removal is a commonly performed procedure. While implant removal can be associated with<br />improved symptoms, risks of the surgery are notable. Stripped screws, broken and retained hardware, and morbidity<br />associated with soft tissue compromise during difficult removal are all common. Familiarity with the instruments is<br />critical to procedure success. The purpose of this study is to assist removal of unfamiliar screws in upper extremity<br />surgery by offering a reference for screw and driver compatibility across manufacturers.<br />Inclusion of device manufacturers was determined by market share. Screw size, drive configuration, and screw removal<br />system compatibility data was collected and recorded. Screw, guide-wire, and screwdriver compatibility was assessed<br />and compared to two commonly utilized universal implant-removal sets.<br />Eight upper extremity implant vendors were included. The data was compiled in table format according to manufacturer<br />and sub-categorized to facilitate screw identification according to radiographically identifiable characteristics.<br />The diversity of orthopaedic implants in upper extremity surgery requires careful preoperative planning to identify the<br />appropriate equipment for implant removal.<br />The goal of this work is to provide a centralized reference of commonly implanted screws, guide-wires, and drivers for<br />the upper extremity to facilitate removal.<br />Level of evidence: V