Broken screw

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I had a patient last week with a broken Charlotte screw. The middle of the Charlotte (like a Herbert screw) is non threaded and I had a bear of a time getting it out.

Does anyone know of a screw extractor that works for these non threaded screws?

Steve

 

Steve,

I saw a picture of the screw. Could you use a needle nose pliers, or a mosquito hemostat to grab it? If it sticks out, surgical vice grips work well.

Regards,

Stanley

 

"I saw a picture of the screw. Could you use a needle nose pliers, or a mosquito hemostat to grab it? If it sticks out, surgical vice grips work well."

Hi Stanley:
It was a failed first met-cun fusion. The screws were 3.5 and I just couldn't get the screw extractor to grab onto the shaft (no threads) which was quite far below the level of the cortex. There was nothing I could get down into the "hole" to grab the screw with.

I ended up redoing the fusion, using a small laminaspreader to get to the screw where it crossed the old joint line. I was able to distract enough to get a small kelly onto the shaft and unscrew it and remove it through the joint.

Not the way I wanted to do it.

The screw extractors work great when there are threads to grab onto. I've not had one of these "herbert" type screws break before and I think it's enough reason not to use them anymore if there isn't a way to deal with complications.

Steve

 

Did you think of using a small burr and circumscribing the head of the screw?

Regards,

Stanley

 

"Did you think of using a small burr and circumscribing the head of the screw?"
Hey Stanley.
The head wasn't the problem, I got that out quickly.
THe problem was the deep broken smooth shaft.

Steve

 

Hey Steve,

How about using a trephine, then packing the hole with bone chips?

Regards,

Stanley