Clinical review of patients with broken Harrington rods.

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Abstract
Medical records and roentgenograms of 2016 patients who were operated on from 1961 through 1974 using Harrington spinal instrumentation were reviewed to determine the incidence, clinical significance, and management of broken distraction and compression rods. The cases were divided into 2 study groups. Group A includes 1128 patients operated on from 1961 through 1968, when no autogenous iliac bone graft material was used, and group B includes 888 patients operated on from 1969 through 1974, when autogenous bone was used. The incidence of broken distraction rods was 12.5% (141 patients) in group A and 2.1% (19 patients) in group B. The age of the patient at operation was not a significant factor when comparing patients with fractured rods and those with intact rods; preoperative curve magnitude influenced the incidence of rod fractures. Reinstrumentation of distraction rods was required in 23 patients from group A, but no patients in group B required reinstrumentation. Eleven patients from group A required removal of the rods. The compression rod fractured in 40 patients (3.5%) in group A and in 1 patient in group B; none required reinstrumentation or rod removal. The clinical management of rod fractures must be individualized for each patient. Reinstrumentation and fusion may be indicated in patients with early rod fracture, total loss of correction or overlapping of the rod, but not in patients experiencing little or no loss of correction and no associated symptoms.

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