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Case Reports
. 2015 Nov-Dec;133(6):531-4.
doi: 10.1590/1516-3180.2014.9061512. Epub 2015 Oct 9.

Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report

Abhijeet Ashok Salunke  1 , Prem Haridas Menon  2 , Gurunathampalayam Ilango Nambi  3 , Junhao Tan  4 , Vivek Patel  5 , Yongsheng Chen  2 , Jay Kumar  5
Affiliations
Case Reports

Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report

Abhijeet Ashok Salunke et al. Sao Paulo Med J. 2015 Nov-Dec.

Abstract
in English, Portuguese

Context: Hardware breakage during hip surgery can pose challenging and difficult problems for orthopedic surgeons. Apart from technical difficulties relating to retrieval of the broken hardware, complications such as adjacent joint arthritis and damage to neurovascular structures and major viscera can occur. Complications occurring during the perioperative period must be informed to the patient and proper documentation is essential. The treatment options must be discussed with the patient and relatives and the implant company must be informed about this untoward incident.

Case report: We report a case of complete removal of the implant and then removal of the broken guidewire using a combination of techniques, including a cannulated drill bit, pituitary forceps and Kerrison rongeur.

Conclusions: We suggest some treatment options and recommendations for preventing an avoidable surgical catastrophe.

CONTEXTO:: Ruptura de material de síntese durante a cirurgia de quadril pode representar problemas desafiadores e difíceis para cirurgiões ortopédicos. Além de dificuldades técnicas com recuperação do material quebrado, complicações como artrite na articulação adjacente, danos às estruturas neurovasculares e às principais vísceras podem ocorrer. A complicação durante o período perioperatório deve ser informada ao paciente e documentação apropriada é essencial. As opções de tratamento devem ser discutidas com o paciente e seus familiares e a empresa do implante deve ser informada sobre este incidente desagradável.

RELATO DE CASO:: Nós relatamos um caso da remoção completa do implante e, em seguida, a remoção do fio-guia quebrado usando uma combinação de técnicas, incluindo uma broca canulada, fórceps da hipófise e rongeur de Kerrison.

CONCLUSÕES:: Sugerimos algumas opções de tratamento e recomendações para prevenir uma evitável catástrofe cirúrgica.

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Conflict of interest statement

Conflict of interests: None

Figures

Figure 1
Figure 1. Preoperative radiograph showing Evan's type 4 left intertrochanteric hip fracture (white arrow).
Figure 2
Figure 2. Postoperative radiographs produced after the primary surgery in anteroposterior view (white arrow) and lateral view (black arrow), showing broken guidewire in hip joint and short femoral nail.
Figure 3
Figure 3. Postoperative radiographs produced after revision
See this image and copyright information in PMC

References

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