Removal of a broken guide wire entrapped in a fractured femoral neck

Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac- ture of the right femor...

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Published inChinese journal of traumatology Vol. 16; no. 4; pp. 237 - 239
Main Authors Zhu, Qing-hua, Ye, Tian-wen, Guo, Yong-fei, Wang, Chong-li, Chen, Ai-min
Format Journal Article
LanguageEnglish
Published China Elsevier B.V 01.08.2013
Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University,Shanghai 200003, China%Image Center, PLA 251 Hospital, Zhangjiakou, Hebei Province, China
Elsevier
Subjects
Bone Wires - adverse effects
Bones wires
Complications
Device Removal
Femoral neck fractures
Femoral Neck Fractures - diagnostic imaging
Femoral Neck Fractures - surgery
Fracture Fixation, Internal - methods
Humans
Male
Middle Aged
Radiography
内固定
包裹
导丝
操作过程
破碎
空心钻头
股骨头坏死
骨折
Complications
Femoral neck fractures
Bones wires
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Summary:Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac- ture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotat- ing arotmd the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the bro-ken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixa- tion was easily finished. The patient had an uneventful re- covery without avascular necrosis of femoral head or non- union of the fracture at one year＇s follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.
Bibliography:Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac- ture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotat- ing arotmd the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the bro-ken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixa- tion was easily finished. The patient had an uneventful re- covery without avascular necrosis of femoral head or non- union of the fracture at one year＇s follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.
Femoral neck fractures; Bones wires; Complications
50-1115/R
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ISSN:1008-1275
DOI:10.3760/cma.j.issn.1008-1275.2013.04.011