Endovascular assisted removal of intrapelvic lag screw after intramedullary proximal femoral nail: A case report and literature review

Background: Trochanteric fractures are very common hip injuries often fixed with intramedullary nailing as the recommended treatment. Medial lag screw migration of the intramedullary nail system is an uncommon complication. The objective of this case report is to highlight the importance of optimal...

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Bibliographic Details
Main Authors: Zakaria Mousati, Mathias Van Den Broek, Joren Callaert, Jan Gielis, Kris Govaers
Format: Article
Language:English
Published: Elsevier 2023-08-01
Series:Trauma Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352644023001218
Description
Summary:Background: Trochanteric fractures are very common hip injuries often fixed with intramedullary nailing as the recommended treatment. Medial lag screw migration of the intramedullary nail system is an uncommon complication. The objective of this case report is to highlight the importance of optimal reduction in hip fractures and the need for a multidisciplinary approach with vascular assistance in intrapelvic lag screw migration. Case report and results: We collected 24 cases of intrapelvic migration of the lag screw in the latest literature. Here, we report the case of a 68-year-old patient with medial pelvic migration of the lag screw after minor trauma and its removal using peroperative simultaneous angiography. After removal of the osteosynthesis material, a revision to a total hip arthroplasty was performed. Conclusion/discussion: This is the first case demonstrating an endovascular assisted removal simultaneous with revision surgery. We suggest that a multidisciplinary approach is warranted in which the orthopedic surgeon is assisted by a vascular surgeon. An endovascular assisted open removal of the lag screw with conversion to a hip arthroplasty is considered a safe treatment.
ISSN:2352-6440