Acutrak® Screw

Removal Technique
 Screw Removal Introduction
Acumed® is a global leader of innovative
orthopaedic and medical solutions.

We are dedicated to developing products,

service methods and approaches that
improve patient care.

Contents
Screw Removal Introduction 2
Features and Benefits 3
The Acumed® Screw Removal System is a complement to our
Screw Removal Tool Usage Chart 4
innovative Acumed® Plates and Acutrak® Headless Compression
Acutrak® Screw Removal Steps 5 Screws. Each component of the extensive system is designed
Surgical Removal Techniques specifically for our plating systems and Acutrak® Screws, with
Acutrak® Screw 6 customized geometry to exactly match our products. The versatility of
Plate Screw 8 the system is designed to allow you to use the instrumentation in
Ordering Information 10 screw removal situations you are presented with in surgery.

Solid Hex Driver Easyout Left-Handed Drills

ŹŹ Cannulation removed to ŹŹ Cutting flutes to grasp ŹŹ Tip specifically designed for

increase strength stripped hex drilling titanium implants
ŹŹ Geometry designed for
screw removal

2
 Features and Benefits
Customized Design
The distinct geometry of the Acumed® Screw Removal System is tailored
to match our product line to enable efficient removal in
screw removal situations.

Ease of Use
All of our removal instrumentation is easy to assemble and use. A-O
quick releases are provided on all instrumentation.

Trephine Screw Removal Tip Impact Driver

ŹŹ Tapered interior to ŹŹ Force fit on threads to lock ŹŹ For use with Acutrak® Plus,
encapsulate proximal portion the screw Acutrak® 6/7 and
of screw Acutrak 2® - 5.5 Headless
Compression Screws

3
 Screw Removal Tool Usage Chart

Solid Drivers Easyouts Left-Handed Drills

80-0636 (Cruciform)
HPC-0025 (2.5 mm)
80-0583 (1.5 mm)

80-0632 (2.0 mm)

80-0633 (3.0 mm)

80-0634 (3.5 mm)

80-0635 (4.0 mm)

80-0598 (1.5 mm)

80-0599 (2.0 mm)

80-0600 (2.5 mm)

80-0601 (3.0 mm)

80-0602 (3.5 mm)

80-0604 (4.0 mm)

80-0399 (1.5 mm)

80-0400 (2.0 mm)

80-0401 (2.5 mm)

80-0402 (3.0 mm)

80-0403 (3.5 mm)

80-0404 (4.0 mm)

80-0760 (T15)
80-0759 (T8)
Screws
Acutrak® Mini
Acutrak® Standard < 20 mm
Acutrak® Standard > 20 mm
Acutrak® 4/5
Acutrak® Plus
Acutrak® 6/7
Acutrak 2® Micro
Acutrak 2® Mini
Acutrak 2® Standard
Acutrak 2® - 5.5
2.3 CO Screws
2.7 CO, COL and Tap-Loc® Screws
3.5 CO, COL and Tap-Loc® Screws
2.7 Hexalobe Screws
3.0 Hexalobe Screws
3.5 Hexalobe Screws
Cruciform Screws

Trephines Removal Tips Impact Drivers

80-0605 (3.0 mm)

80-0606 (4.0 mm)

80-0205

80-0206

80-0207

80-0208

80-0209

80-0210

80-0211

80-0212

80-0213

80-0214

80-0216

80-0217

80-0612

80-0613

80-0614

80-0615

80-0616

Screws
Acutrak® Mini
Acutrak® Standard < 20 mm
Acutrak® Standard > 20 mm
Acutrak® 4/5
Acutrak® Plus
Acutrak® 6/7
Acutrak 2® Micro
Acutrak 2® Mini
Acutrak 2® Standard
Acutrak 2® - 5.5
2.3 CO Screws
2.7 CO, COL and Tap-Loc® Screws
3.5 CO, COL and Tap-Loc® Screws
2.7 Hexalobe Screws
3.0 Hexalobe Screws
3.5 Hexalobe Screws
Cruciform Screws

4
 Acutrak® Screw Removal Steps

Screw is
not broken

Solid Drivers Easyouts Trephines Removal Tips Impact Drivers

3.0 and 4.0
Hex sizes only

Hex is stripped

Screw is broken

Proximal

Solid Drivers Easyouts Trephines Removal Tips Impact Drivers

3.0 and 4.0
Hex sizes only

Distal Left-Handed
Drills

5
 Acutrak® Screw Removal Surgical Technique

The Acumed® Screw Removal System is designed for straightforward

and efficient screw removal. The following pages detail proper removal
techniques, including tips and guidelines for removing screws when
there is resistance or other difficulties.

1
Using the Driver
ŹŹ Clean out the hex in the screw.
ŹŹ Using the solid hex driver, try to remove the screw. It may
help to advance the screw approximately a quarter turn to
break the bond between the titanium and the bone.
ŹŹ Turn the driver slowly and firmly making sure to keep the
driver in line with the screw.
ŹŹ If there is resistance or a risk of breakage, proceed to the
next step.

2
Using the Easyouts
ŹŹ Make sure the hex is clear.
ŹŹ The Easyouts should be turned by hand.
ŹŹ Turn the Easyout counter-clockwise with firm constant
pressure in line with the screw. It may help to offset the
Easyout by a couple of degrees so it wedges into the head of
the screw.
ŹŹ If the Easyout is spinning, tap it with a mallet to move it
further inside the hex.
ŹŹ If the Easyout doesn’t engage the hex or strips the hex,
proceed to the next step.

3
Using the Trephines
ŹŹ The Trephines are designed for specific screws and for coring
small amounts of bone away from the screw while internally
engaging on the threads of the screw.
ŹŹ The Trephines need to be used under power, at low rpm’s,
high pressure, and in reverse.
ŹŹ A guide wire may be used to help line up the Trephine, which
is cannulated, but it is not required.
ŹŹ If using a guide wire, insert the guide wire into the screw’s
cannulation and then place the Trephine over the guide wire
and push down until it contacts the bone around the screw.
ŹŹ If not using a guide wire just place the Trephine over the end
of the screw.
ŹŹ If the Trephine engages the screw, the screw will start to back
out of the hole. Keep rotating until the screw is completely
out of the hole.
ŹŹ If the Trephine doesn’t engage the screw, stop and proceed
to the next step. The removal tip is designed to fit in the core
created by the Trephine.
6
 Acutrak® Screw Removal Surgical Technique

4
Using the Removal Tip
ŹŹ Thread the removal tip on the end of the supplied quick
release shaft and place over the screw.
ŹŹ The screw removal tip should be used by hand.
ŹŹ Firmly tap the tip onto the end of the screw.
ŹŹ A mallet may be used to make sure the tip is firmly attached
to the screw.
ŹŹ Rotate the tip counter-clockwise until the screw is removed.

5
Using the Left-Handed Drill
ŹŹ If the screw is broken and the proximal portion of the screw
is removed, assess the amount of the screw that is left.
ŹŹ If you have more than half of the screw, use the same size
left-handed drill as the hex size of the screw you
are removing.
ŹŹ If you have less then half of the screw, use the next smallest
left-handed drill.
ŹŹ Using the drill in reverse, insert the drill tip into the
cannulation of the fragment.
ŹŹ With a low to medium drill speed and high pressure, drill out
the cannulation to a depth of approximately 4 mm to 5 mm.
ŹŹ The drill flutes may serve to remove the fragment.
ŹŹ If the drill does not remove the fragment, use the same size
Easyout to remove it.

6
Using the Impact Drivers
ŹŹ The impact drivers are designed to be used with Acutrak®
Plus, Acutrak® 6/7 and Acutrak 2® - 5.5 screws. They should
only be used if all the preceding removal steps did not
remove the screw.
ŹŹ To use the impact driver, place the tip of the impact driver in
the screw hex.
ŹŹ Place the impact driver handle over the hex end of the
impact driver.
ŹŹ Using a mallet lightly tap the impact driver to wedge the tip
into the screw hex.
ŹŹ Rotate the impact driver counter-clockwise until the screw
is removed.

7
 Plate Screw Removal Surgical Technique

Techniques for plate screw removal are similar to those of the

Acutrak® Screw removal, but not exactly the same. So be sure to
carefully follow the tips and guidelines as described.

1
Using the Driver
ŹŹ Clean out the hex in the screw.
ŹŹ Use the solid hex driver to try and remove the screw. It may
help to initially try and advance the screw approximately a
quarter turn to break the bond between the titanium and
the bone.
ŹŹ Turn the driver slowly and firmly making sure to keep the
driver in line with the screw.
ŹŹ If there is resistance or a risk of breakage, proceed to the
next step.

2
Using the Easyouts
ŹŹ Make sure the hex is clear.
ŹŹ The Easyouts should be turned by hand.
ŹŹ Turn the Easyout counter-clockwise with firm constant
pressure in line with the screw.
ŹŹ It may help to offset the Easyout by a couple degrees so it
wedges into the head of the screw.
ŹŹ If the Easyout is spinning, tap it with a mallet to get it further
inside the hex.
ŹŹ If the Easyout does not engage the hex or if there is a risk of
splitting, proceed to next step.

3
Using the Left-Handed Drill
ŹŹ Use the left-handed drill inverse to remove the head of
the screw.
ŹŹ The drill may act as an Easyout and remove the screw instead
of removing the head. Regardless, you should remove the
plate from the bone.
ŹŹ If one of the screws could not be removed and the drill did
not remove the head, use a burr to cut the plate on either
side of the remaining screw and then remove the plate.
ŹŹ Use suction to vacuum up the chips.
ŹŹ Once the plate is removed go to the next step.
8
 Plate Screw Removal Surgical Technique

4
Using the Trephines
ŹŹ The Trephines are designed for specific screws and for coring
small amounts of bone away from the screw while internally
engaging on the threads of the screw.
ŹŹ The Trephines need to be used under power, at low rpm’s,
high pressure and in reverse.
ŹŹ A guide wire may be used to help line up the Trephine, which
is cannulated, but it is not required.
ŹŹ If using a guide wire, insert the guide wire into the screw’s
cannulation and then place the Trephine over the guide wire
and push down until it contacts the bone around the screw.
ŹŹ If not using a guide wire just place the Trephine over the end
of the screw.
ŹŹ If the Trephine engages the screw, the screw will start to back
out of the hole. Keep rotating until the screw is completely
out of the hole.
ŹŹ If the Trephine doesn’t engage the screw, stop and proceed
to the next step. The removal tip is designed to fit in the core
created by the Trephine.

5
Using the Removal Tip
ŹŹ Thread the removal tip on the end of the supplied quick
release shaft and place over the screw.
ŹŹ The screw removal tip should be used by hand.
ŹŹ Firmly tap the tip onto the end of the screw.
ŹŹ A mallet may be used to make sure the tip is firmly attached
to the screw.
ŹŹ Rotate the tip counter-clockwise until the screw is removed.

Screw Removal Steps

CO & COL
Screw Plates

Solid Drivers Easyouts Left-Handed Trephines

Drills
Removal Tips

If the Easyout does

not engage the hex,
drill off the head of the
screw and remove the
plate. You can then
use Trephines to
remove screws.
9
 Acutrak® Removal Ordering Information

Acutrak® Screw Removal Part # QtyPerSet

1.5 mm Quick Release Solid Hex Driver 80-0583 2 Plus Trephine 80-0206 2
2.0 mm Quick Release Solid Hex Driver 80-0632 2 6/7 Trephine 80-0205 2
2.5 mm Quick Release Solid Hex Driver HPC-0025 2 Acutrak 2® Standard Trephine 80-0211 2
3.0 mm Quick Release Solid Hex Driver 80-0633 2 Acutrak 2® Mini Trephine 80-0212 2
3.5 mm Quick Release Solid Hex Driver 80-0634 2 Acutrak 2® Micro Trephine 80-0213 2
4.0 mm Quick Release Solid Hex Driver 80-0635 2 Acutrak 2® - 5.5 Trephine 80-0214 2
1.5 mm Easyout 80-0598 2 3.0 mm Impact Driver Tip 80-0605 1
2.0 mm Easyout 80-0599 2 4.0 mm Impact Driver Tip 80-0606 1
2.5 mm Easyout 80-0600 2 Micro Removal Tip 80-0612 3
3.0 mm Easyout 80-0601 2 Mini Removal Tip 80-0613 3
3.5 mm Easyout 80-0602 2 Standard Removal Tip 80-0614 3
4.0 mm Easyout 80-0603 2 Large Removal Tip 80-0615 3
1.5 mm Left-Handed Drill 80-0399 2 Extra Large Removal Tip 80-0616 3
2.0 mm Left-Handed Drill 80-0400 2 Screw Removal Tip Shaft 80-0610 1
2.5 mm Left-Handed Drill 80-0401 2 Removal Tip Wrench 80-0611 1
3.0 mm Left-Handed Drill 80-0402 2 Impact Driver Handle 80-0607 1
3.5 mm Left-Handed Drill 80-0403 2 Vise Grips Teleflex: KM48600 80-0617 1
4.0 mm Left-Handed Drill 80-0404 2 T-Handle, Silicone, A-O Connector 80-0637 1
Acutrak® Mini Trephine 80-0210 2 Periosteal Elevator MS-46211 1
Acutrak® Standard Trephine < 20 mm 80-0209 1 Sharp Hook PL-CL06 1
Acutrak® Standard Trephine > 20 mm 80-0208 1 Acutrak® & Acutrak 2® Screw Removal
80-0586 1
Tray Assembly
4/5 Trephine 80-0207 2

10
 Plate Screw Removal Ordering Information

Plate Screw Removal Part # Qty per Set

3.5 CO Trephine 80-0216 2
2.7 -2.3 CO Trephine 80-0217 2
2.5 mm Left-Handed Drill 80-0401 2
3.0 mm Left-Handed Drill 80-0402 2
1.5 mm Solid Hex Driver Tip,
80-0583 2
Quick Release
1.5 mm Easyout 80-0598 4
2.5 mm Easyout 80-0600 4
Screw Removal Tip Shaft 80-0610 1
Removal Tip Wrench 80-0611 1
Micro Removal Tip 80-0612 6
Mini Removal Tip 80-0613 6
Locking Pliers, Small 80-0617 1
Cruciform Driver Tip, Quick
80-0636 2
Release
T-Handle, Small, Fixed, Quick
80-0637 1
Release Connector
2.5 mm Quick Release Solid Hex Driver HPC-0025 2
Periosteal Elevator MS-46211 1
Sharp Hook PL-CL06 1
Universal Tray Plate & Screw
80-0474 1
Removal Assembly

To learn more about the full line of Acumed® innovative

surgical solutions, including the Screw Removal System,
please contact your local Acumed® Sales Representative or
call 888-627-9957.

11
5885 NW Cornelius Pass Road
Hillsboro, OR 97124
(888) 627-9957
www.acumed.net

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the reader is located. Specific questions physicians may have about the availability and use
of the products described on these materials should be directed to their particular local sales
SPF10-00-C representative. Specific questions patients may have about the use of the products described
Effective 8/2012 in these materials or the appropriateness for their own conditions should be directed to their
© 2012 Acumed® LLC own physician.