Equipment failure during mandibular staple bone plate insertion and a technique to resolve it

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Orthopedic Surgery

Background:

• The mandibular staple bone plate is utilized in specific mandibular fracture repairs.
• Drill guides are essential instruments for accurate placement of bone plates.
• Set screws are critical components for securing surgical instruments during procedures.

Observation:

• Intraoperative fracture of the set screw within the drill guide was observed.
• This fracture led to the surgical apparatus being irremovable.
• The mandibular staple bone plate system was implicated in the complication.

Findings:

• The fractured set screw obstructed the removal of the drill guide.
• A novel problem-solving approach was required to address the intraoperative complication.
• Successful removal of the apparatus was achieved by sectioning the director rods.

Implications:

• This case highlights a potential failure mode in surgical drill guide design.
• Clinicians should be prepared for unexpected instrument failures during surgery.
• Alternative removal techniques may be necessary when standard methods are impeded.