To introduce a new broken pedicle screw fragment retrieval instrument, and evaluate its clinical viability and effectiveness.
Following basic retrieval contrivance of broken pedicle screws described in literature, a new retrieval instrument was designed and developed; introducing its mechanism, technical components, and use. This innovative apparatus proved successful not only in saw bone and cadaver trials but in 10 clinical cases as well.
This particular unique instrument successfully retrieves broken pedicle screw fragments through original passage backing out the screw with preservation of pedicle integrity while maintaining pedicle biomechanics. No complications were observed.
With solid scientific theoretical planning and experimentation, the new retrieval instrument design proved clinical practicality and efficacy.
Journal of Spinal Disorders & Techniques 03/2007; 20(1):82-4. DOI:10.1097/01.bsd.0000211257.82755.f6 · 1.89 Impact Factor
To investigate the treatment of infected total knee arthroplasty (TKA).
Between 1983 and 2000, 6 patients with infection after TKAs were treated, including 2 men and 4 women, aged on average 63 years (44 - 75 years). Initial knee arthroplasty was performed for osteoarthritis in 4 patients and for rheumatoid arthritis in 2 knees. The timing of diagnosis of infection after knee arthroplasty averaged 50 months (range, 1 month-11 years). Simple debridement and antibiotic treatment were prescribed for 3 patients, debridement and one-stage reimplantation for 1, debridement and two-stage reimplantation for 1, and athrodesis for 1.
Of the 3 patients with simple debridement, one was cured, one failed but underwent athrodesis later, and one lost to follow up. Two patients with reimplantation were cured and had good function recovery. All of the 6 patients were followed up on average for 4 years. No infection recurred except one who lost to follow-up.
Management of infection after total knee arthroplasty includes antibiotic suppression and debridement with prosthesis retention, insertion of another prosthesis as a one-stage or two-stage exchange technique, knee arthrodesis and amputation. These treatments have specific indications. To treat infection after total knee arthroplasty, suitable method should be taken according to patient's condition. Arthrodesis is the best salvage operation, though it may handicap patients' daily life. Reimplantation of another prosthesis could maintain a functional joint.
Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2002; 40(9):669-72.
To discuss the causes and treatments of wound infections after scoliosis surgery.
Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively.
All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence.
Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.
Chinese Medical Sciences Journal 10/2002; 17(3):193-8.