The Journal of Bone and Joint Surgery, Vol 62, Issue 8 1302-1307, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Clinical review of patients with broken Harrington rods
WD Erwin, JH Dickson and PR Harrington
The medical records and roentgenograms of 2,016 patients who were operated
on from 1961 through 1974 using Harrington spinal instrumentation were
reviewed to determine the incidence, clinical significance, and management
of broken distraction and compression rods. The cases were divided into two
study groups. Group A includes 1,128 patients operated on from 1961 through
1968, when no autogenous iliac-bone graft material was used, and Group B
includes 888 patients operated on from 1969 through 1974, when autogenous
bone was used. The incidence of broken distraction rods was 12.5 per cent
(141 patients) in Group A and 2.1 per cent (nineteen patients) in Group B.
The age of the patient at operation was not found to be a significant
factor when comparing patients with fractured rods and those with intact
rods; however, preoperative curve magnitude was found to influence the
incidence of rod fractures. Reinstrumentation of distraction rods was
required in twenty-three patients from Group A, but no patients in Group B
required reinstrumentation. Eleven patients from Group A required removal
of the rods. The compression rod fractured in forty patients (3.5 per cent)
in Group A and in one patient in Group B; none required reinstrumentation
or rod removal. The clinical management of rod fractures must be
individualized for each patient. Reinstrumentation and fusion may be
indicated in patients with early rod fracture, total loss of correction, or
overlapping of the rod, but not in patients experiencing little or no loss
of correction and no associated symptoms.
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