1/26. Retrieval of a broken needle in the pterygomandibular space.BACKGROUND: Dental needle breakage can be a devastating experience for both practitioners and patients. The authors describe the surgical management for localizing a broken dental needle in the pterygomandibular space and how to prevent needle breakage. CASE DESCRIPTION: The authors present the case of a 35-year-old man who had a chief complaint of pain and the ability to feel a broken needle during mandibular movements after receiving an inferior alveolar nerve block from his general dentist before dental treatment. Surgical management involved localizing the broken needle using radiographs and removing the broken needle under general anesthesia. CLINICAL IMPLICATIONS: Preventing needle breakage is important, as it can be a traumatic experience for the patient. Practitioners should establish the patient's cooperation by explaining to him or her what to expect before injection. Practitioners also should routinely inspect dental needles before administering injections and minimize the number of repeated injections using the same needle.- - - - - - - - - - ranking = 1keywords = breakage (Clic here for more details about this article) |
2/26. Management of a broken needle at the time of laparoscopic burch.Loss of surgical instrumentation in endoscopic procedures poses problems not faced in traditional surgery. We describe the breakage and subsequent recovery of a 2-mm segment of needle from an Autosuture Endostitch device (U.S. Surgical) during a laparoscopic Burch urethropexy.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
3/26. Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws.The purpose of this study was to evaluate 2 cases in which bioabsorbable screw fixation for an osteochondritis dissecans lesion of the femoral condyle resulted in complications necessitating the need for secondary surgery. We reviewed the case history of these patients and described the circumstances under which the bioabsorbable screws were used, the events leading to the need for secondary surgery, and the ultimate outcome. In the 2 cases presented, these implants were found to retain their mechanical stiffness for many months. This resulted in articular damage in 1 case after the treated lesion failed to heal. In the second case, screw breakage 8 months after implantation resulted in it becoming a loose body, which required removal during a second arthroscopic procedure. We conclude that these implants retain their mechanical properties for many months and cannot be relied on to degrade quickly. If a treated lesion fails to heal, these implants can cause mechanical problems due to their retained structural properties.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
4/26. Penetrating injury of the brain by the burr of a high-speed air drill during craniotomy: case report.The most critical complications of craniotomy are caused by the plunging of a skull drill, and there have been no reports of penetrating brain injury caused by the broken burr of a high-speed air drill during craniotomy. Left orbitofrontal craniotomy was performed to clip two aneurysms in a 44 year old man. While cutting the lateral orbital rim with the burr of an Ultra Power surgical drill system, the burr broke off and penetrated the frontal lobe down to the falx cerebri. There were no discernible contusion or haemorrhage in the brain. The accident occurred because a long burr for the angled attachment of a Surgairtome was erroneously attached to the angled attachment of an UltraPower surgical drill. The mismatch between the steel strength and torque of the two burrs designed for different drill systems seemed responsible for breakage of the burr. We learned a valuable lesson from this failure: that all new instruments, including high-speed air drills, must be studied carefully so that staff become thoroughly familiar with their handling.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
5/26. Secondary intra-articular dislocation of a broken bioabsorbable interference screw after anterior cruciate ligament reconstruction.We report a case of intra-articular migration of the proximal part of a broken polylactic acid screw from the tibial site of anterior cruciate ligament-reconstruction with quadrupled semi-tendinosus tendon. Five months after initially successful ACL surgery the patient felt a sudden locking of the knee without another injury. MRI showed intra-articular migration of one-half of the polylactic acid screw, and standard radiographs a widening of the proximal tibial tunnel. At revision arthroscopy the broken part was easily removed. The patient had full recovery. This case demonstrates the problem of "bioscrew" breakage in ACL surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
6/26. The implications of a broken needle in the pterygomandibular space: clinical guidelines for prevention and retrieval.The implication of a broken anesthetic injection needle in the posterior part of the oral cavity is described. Needle breakage is preventable if proper preventive measures are used during local anesthesia administration. A broken needle should be removed immediately after a thorough localization and not left in the tissue, as previously believed. Computerized tomography (CT) scan is the proper diagnostic device to locate a broken needle. A careful surgical approach under general anesthesia is recommended to retrieve the needle. Clinical preventive guidelines are described and presented to the pediatric dentist.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
7/26. The breaking of an intrathecally-placed epidural catheter during extraction.IMPLICATIONS: Misplacement of an epidural catheter into the subarachnoid space is a recognized complication. However, breakage of an intrathecal epidural catheter during removal presents a dilemma. Appropriate imaging, a neurosurgical consultation, and aggressive surgical exploration and extraction of the retained piece are warranted, even in the asymptomatic patient.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
8/26. Bilateral mycotic axillary artery false aneurysms in an intravenous drug user: unsuspected broken needle-tips pose a risk to the treating personnel.Mycotic false aneurysms due to local arterial injury from attempted intravenous injections in drug addicts are increasing in frequency. The high incidence of hiv and hepatitis b virus in parenteral drug users may present a considerable risk to the treating personnel. This paper reports the unsuspected presence of broken needle-tips in the subcutaneous tissues of an intravenous drug abuser, in association with bilateral mycotic aneurysms of the axillary arteries. Broken needle-tips have the potential to cause needlestick injury to the operating team and the nursing staff, with the associated risk of transmission of hiv and hepatitis b virus infection. The presence of broken needle-tips should be suspected in drug users presenting with false aneurysms associated with local arterial injection injury and a specific history of needle-breakage should be sought. Preoperative plain radiographs should be performed of the planned operative field to exclude the presence of such needle-tips. Any soft tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
9/26. Loose intra-articular body following anterior cruciate ligament reconstruction.We report a case of intra-articular fracture of a bioabsorbable fixation device from the femoral tunnel in an anterior cruciate ligament reconstruction using a bone-tendon-bone graft. Thirteen months after successful reconstruction surgery, the patient experienced episodes of locking and medial joint pain. There was no history of trauma and no symptoms of instability or swelling. On revision arthroscopy, a fractured tip of a bioabsorbable RIGIDfix cross pin (Mitek, Westwood, MA) was identified in the medial compartment of the knee. There was a broad area of chondral erosion affecting the medial femoral condyle and a small defect to the medial tibial plateau where the loose body had been lodged. The bone-tendon-bone graft was intact without disruption. After arthroscopy, the patient was symptom free for 3 weeks but then developed further symptoms of locking. magnetic resonance imaging showed another loose body within the knee. A repeat arthroscopy was performed 6 weeks after the earlier procedure and another piece of the polylactic acid RIGIDfix cross pin was removed, this time from the lateral gutter. This case raises concern about the potential for breakage and resultant loose body formation that may occur after bioabsorbable cross-pin fixation and, particularly, the associated chondral damage that can occur if early intervention is not conducted.- - - - - - - - - - ranking = 0.33333333333333keywords = breakage (Clic here for more details about this article) |
10/26. Multiple retained needles: an unusual complication of intracavernous self-injection.Intracavernous self-injection of pharmacologic agents is an effective method of treatment of erectile dysfunction. Intracorporeal needle breakage is a rare complication of intracavernosal self-injection. We report an unusual case of multiple retained needles in a 44-year-old man who presented with penile edema after intracavernous self-injection complicated by needle breakage. The patient was treated with nonoperative therapy and observed on a course of antibiotics to which he responded favorably. He continued to have good erectile function. We also present a review of the reported data and recommend a treatment strategy for the management of retained intracorporeal needles.- - - - - - - - - - ranking = 0.66666666666667keywords = breakage (Clic here for more details about this article) |
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