Eastman Jonathan G, Firoozabadi Reza, Cook Laurence E, Barei David P
Orthopedics. 2016 May 1;39(3):e582-6. doi: 10.3928/01477447-20160414-04. Epub 2016 Apr 18.
In fractures with varying degrees of comminution, it is possible for cortical bone fragments to become entrapped within the intramedullary canal. There have been prior case reports on complications associated with incarcerated fragments; however, there has been no proposed solution. The current case shows how 2 cortical fragments in the distal segment of a comminuted femur fracture impeded passage of the intramedullary reamer and induced deformity at the fracture site during the reaming. The authors describe a simple method of retrieval without having to formally open the fracture site. Recognizing the presence of an incarcerated fragment and appropriately managing it intraoperatively allows for fracture fixation to occur uneventfully. [Orthopedics. 2016; 39(3):e582-e586.].
在不同粉碎程度的骨折中，皮质骨碎片有可能被困于髓腔内。此前已有关于与嵌顿碎片相关并发症的病例报告；然而，尚未提出解决方案。本病例展示了在粉碎性股骨骨折远侧段的2块皮质碎片如何在扩髓过程中阻碍髓内扩孔钻通过并导致骨折部位畸形。作者描述了一种无需正式切开骨折部位的简单取出方法。术中识别嵌顿碎片的存在并进行妥善处理可使骨折固定顺利进行。[《骨科学》。2016年；39(3):e582 - e586。]
