Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen 81675, Germany.
J Orthop Trauma. 2010 Feb;24(2):e6-e11. doi: 10.1097/BOT.0b013e3181a4eeb2.
Within the last decade, intramedullary nailing systems have gained popularity in the treatment of unstable fractures of the trochanteric region with good clinical results. However, these implants are not free of complications. Commonly reported treatment failures include implant cutout through the femoral neck, stress-derived femur fractures at the distal end of the nail, and secondary rotational displacement and varus deformity of the femoral neck and head. Only few reports exist on primary medial migration of the lag screw after treatment with intramedullary implants. We report on a rarely described complication in 2 patients who underwent osteosynthesis with a Gamma 3 nail (Stryker, Mahwah, NJ). Both patients presented with implant failures due to primary medial migration of the lag screw. Complete separation of the implant occurred, and the lag screw penetrated through the acetabulum into the pelvis. The patient's histories and course of treatment are reported. The literature on this topic is discussed.
在过去的十年中，髓内钉系统在治疗不稳定型转子间骨折方面得到了广泛应用，临床效果良好。然而，这些植入物并非没有并发症。常见的治疗失败包括：通过股骨颈的植入物穿出、钉远端的股骨应力性骨折、以及股骨颈和头部的继发性旋转移位和内翻畸形。只有少数关于髓内植入物治疗后拉力螺钉原发性内侧迁移的报告。我们报告了 2 例使用 Gamma 3 钉（Stryker，Mahwah，NJ）进行骨内固定的患者中罕见的并发症。这 2 名患者均因拉力螺钉的原发性内侧迁移而出现植入物失败。植入物完全分离，拉力螺钉穿透髋臼进入骨盆。报告了患者的病史和治疗经过。讨论了该主题的文献。
