The Journal of Bone and Joint Surgery (American). 2008;90:2652-2654.
doi:10.2106/JBJS.H.00163
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Frequency of Instrument Breakage During Orthopaedic Procedures and Its Effects on Patients

Wolfgang Pichler, MD1, Peter Mazzurana, MD2, Hans Clement, MD1, Stephan Grechenig1, Renate Mauschitz, MD1 and Wolfgang Grechenig, MD, Ass. Prof.1

1 Department of Traumatology, Medical University of Graz, Auenbruggerplatz 7a, A-8036 Graz, Austria. E-mail address for W. Pichler: wolfgang.pichler{at}klinikum-graz.at
2 Division of Orthopaedics, Bolzano Central Hospital, Via L. Böhler 5, 39100 Bolzano, Italy

Investigation performed at the Department of Traumatology, Medical University of Graz, Graz, Austria, and the Division of Orthopaedics, Bolzano Central Hospital, Bolzano, Italy

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.


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