06/17/2013    Don R Blum, DPM, JD

Considerations of Re-using a Bone Screw (Joshua Kaye, DPM)

The manufacturer's specifications are for one-
time use. There are companies that will recertify
hardware, like getting a used program car, and
certify that it meets the specifications as well
as repackage the hardware, sterile if required.
This is why once a screw is put in and then one
decides a different size is necessary, there is a
charge for the extra hardware.

What is not seen are microscopic changes occur to
the screw. The threads could be damaged "slightly
(minimally)", to me might not be observable, but
the change is there. The screw has been torqued
when placed in the drill hole and tightened.
Plus the patient has walked and there "could" a
minimal "bend" to the screw. Analogies: in the
more expensive cars when getting am oil change,
the screw plug for the oil pain is replaced.
After a severe car accident, the seat belt does
not meet the specifications for the belt because
the cloth has been stretched, and the threads per
square inch do not meet the specs. By the way,
the insurance companies will not pay for new seat
belts after an accident. One more analogy is a K-
wire the sharp end becomes less sharp after it
has been placed in bone.

My opinion, however, is the screw is probably
going to do what you want, hold the bone
together, however if the screw breaks or the bone
does not heal, this will be the "bone of
contention" in the malpractice suit.

Why are drill bits and taps one time use (I know
that some centers will sterilize them again and
use them until they break, but the specs are
after one use they are sharp and the manufacturer
will warrant the bit or tap.

Don R Blum, DPM, JD, Dallas, TX,
donrblum@sbcglobal.net

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