Accidentally falling instruments during orthopaedic surgery: time to wake up!
BACKGROUND
The aim of the study was to evaluate statistically the occurrence and causes of accidental fall of instruments and implants during orthopaedic procedures.


METHODS
A prospective study was carried out over a period of 18 months. Total of 120 randomly chosen major orthopaedic surgeries were observed. The observer counted the number of times an instrument fell during surgery. The offending operating room personnel were identified. A note of the nature of instrument falling was made.


RESULTS
A total of 120 surgeries were observed. There were 15 falls (38.5%) during elective surgeries and 24 (61.5%) during emergency (trauma) surgeries. Falls were classified as major and minor. There were a total of 39 falls with 11 major and 28 minor falls. Seven surgeries had two or more falls. In 26 instances (66.7%) the operating surgeon was responsible for the fall. In seven (17.9%) assisting surgeon and in three (7.7%) of the instances the scrub nurse was responsible for the fall of the instruments. Three falls (7.7%) were unaccountable. An average delay of 7.6 min was noted after the fall of the instrument or implant.


CONCLUSIONS
Fall of instruments in the theatre is a common problem all over the world. It leads to increased operating time and extra resources and can hamper the end result of surgery. Our study is the first of its kind to evaluate the problem. Most falls occurred because of the operating surgeon. A course in instrument handling similar to one conducted by the theatre nurses may be helpful in preventing such falls.
Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. shahalamkhan@rediffmail.com
Shah A
SA
Khan
Ashok
A
Kumar
Manish K
MK
Varshney
Vivek
V
Trikha
Chandershekar
C
Yadav
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D006801:Humans; D009983:Orthopedic Equipment; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D011446:Prospective Studies; D019736:Prostheses and Implants; D013525:Surgical Instruments