Implant Removal Matrix for the Upper Extremity Orthopedic Surgeon

Orthopedic implant removal is a commonly performed procedure. While implant removal can be associated withimproved symptoms, risks of the surgery are notable. Stripped screws, broken and retained hardware, and morbidityassociated with soft tissue compromise during difficult removal are all common. Familiarity with the instruments iscritical to procedure success. The purpose of this study is to assist removal of unfamiliar screws in upper extremitysurgery by offering a reference for screw and driver compatibility across manufacturers.Inclusion of device manufacturers was determined by market share. Screw size, drive configuration, and screw removalsystem compatibility data was collected and recorded. Screw, guide-wire, and screwdriver compatibility was assessedand compared to two commonly utilized universal implant-removal sets.Eight upper extremity implant vendors were included. The data was compiled in table format according to manufacturerand sub-categorized to facilitate screw identification according to radiographically identifiable characteristics.The diversity of orthopaedic implants in upper extremity surgery requires careful preoperative planning to identify theappropriate equipment for implant removal.The goal of this work is to provide a centralized reference of commonly implanted screws, guide-wires, and drivers forthe upper extremity to facilitate removal.Level of evidence: V