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Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 80-85

Intraoperative instrument breakage during the orthopedic elective procedures: A retrospective single-center experience

Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India

Correspondence Address:
Dr. Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani - 263 139, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JOASP.JOASP_18_20

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BACKGROUND: Fracture fixation accounts for majority of orthopedic surgical interventions with most procedures requiring variety of instruments as part of surgical armamentarium. Breakage of instruments during the operation is unwanted experience and may complicate or lengthen the procedure thus interfering with overall outcome. A study regarding the pattern of intraoperative instrument failures is thus important to gain fruitful insights for not only preventive strategies but for further studies in this context. MATERIALS AND METHODS: A retrospective study of all consecutive incidents of instrument breakage during a 2-year period (January 2017 to December 2019) were recorded with relevant details such as type of surgery, type of implant, type of instrument and the probable cause, management and key demographic details during 2-year period at a tertiary care center in North India. Knowledge about the risk factors was tried to be extracted from our observations. RESULTS: Out of a total 8132 elective major and minor cases during the study period, 30 (0.36%) cases of intraoperative instrument breakage were noted. The types of instrument broken in the descending order with numbers in the bracket were drill bits (5), guidewires (3), manual intramedullary reamers (3), periosteal elevator (3), screwdriver tip, and bone tap in two cases each. The power-driven flexible reamer, screwdriver tip, screwdriver handle, proximal jig for the intramedullary nail, bone nibbler, and bone lever were another instruments with singular incidents. In the general instruments, long artery forceps (4) was the most common to break followed by mosquito forceps (3) and one nose-plier in separate cases. Conclusion: The breakage of surgical and non-implant instruments during the operation is uncommon event but requires proper documentation and due acknowledgement for prohibitive and management guidelines.

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