Medial migration of lag screw after gamma nailing

Eric Thein; Alexandre De Cannière; Alexandre Burn; Olivier Borens

doi:10.1016/j.injury.2014.04.016

Medial migration of lag screw after gamma nailing

Injury. 2014 Aug;45(8):1275-9. doi: 10.1016/j.injury.2014.04.016. Epub 2014 May 10.

Authors

Eric Thein¹, Alexandre De Cannière², Alexandre Burn², Olivier Borens²

Affiliations

¹ Department of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: eric.thein@chuv.ch.
² Department of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland.

PMID: 24933440
DOI: 10.1016/j.injury.2014.04.016

Abstract

Fractures of the proximal femur are common in the elderly population. Intramedullary nailing has become the standard treatment for intertrochanteric fractures although several extramedullary implants (e.g. dynamic hip screw (DHS), blade plate, locking compression plate (LCP), etc.) exist. However, despite this being a very common operation in traumatology, there are numerous associated complications. We report the rare complication of the migration of the medial lag screw into the pelvis at five and a half weeks postoperatively. The implant was removed and replaced by a total hip arthroplasty with simultaneous grafting of the acetabular defect and strapping of the greater trochanter. The evolution was favourable. We also present a review of the literature and analyze our case.

Keywords: Intertrochanteric fractures; Intramedullary nailing; Lag screw medial migration.

Publication types

Case Reports
Review

MeSH terms

Aged
Arthroplasty, Replacement, Hip / methods
Bone Screws*
Device Removal*
Female
Foreign-Body Migration / diagnostic imaging
Foreign-Body Migration / surgery*
Fracture Fixation, Intramedullary / adverse effects
Hip Fractures / diagnostic imaging
Hip Fractures / surgery*
Humans
Pelvis / diagnostic imaging*
Postoperative Complications / diagnostic imaging
Postoperative Complications / surgery*
Radiography
Treatment Outcome