Frequency of instrument breakage during orthopaedic procedures and its effects on patients.

Abstract

While breakage of an orthopaedic instrument is a relatively rare occurrence, orthopaedic surgeons need to be familiar with this complication and how to deal with it. Relatively little information about this subject has been published. Every case of instrument breakage during orthopaedic procedures performed in two hospitals during a two-year period was documented prospectively. All patients were followed for a postoperative period ranging from twelve to thirty-six months, during which radiographs in two planes were made to assess changes in, or migration of, the broken object. During the observation period, 11,856 surgical procedures were performed in the two hospitals. The overall rate of instrument breakage was 0.35%. The broken piece was removed in five cases, and the broken instrument was left in situ in thirty-seven cases. During the follow-up period, none of the patients had any symptoms. In most cases, breakage of an orthopaedic instrument is not a problem. Any instance of instrument breakage should be fully documented in the surgical report.