Llano Lionel, Diaz-Dilernia Fernando, Taype Danilo, Sancineto Carlos, Barla Jorge, Carabelli Guido
Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, 4247 Potosí St., C1199ACK Buenos Aires, Argentina.
Trauma Case Rep. 2019 Jun 20;22:100212. doi: 10.1016/j.tcr.2019.100212. eCollection 2019 Aug.
The intra-articular migration of the spiral lamina or screw, after close reduction and internal fixation (CRIF) with an intramedullary cervicodiaphyseal nail (cut-through), is one of the most frequent postoperative complications. We present a patient with a cut-through and cement leakage into the hip joint after TFN-A cement augmentation and spiral lamina replacement.
A 83-year-old man, suffered a cut-through after CRIF of his left extracapsular hip fracture during the third postoperative month. A revision surgery was planned, including spiral lamina replacement and cement augmentation. Cement leakage into the hip joint was confirmed in the immediate postoperative radiograph and a new intervention was indicated with the removal of the third bodies.
The patient presented good clinical evolution, without functional limitation or pain. In routinely postoperative radiographic controls, no differences were observed respect to the immediate postoperative one.
Current literature dealing with implant revision surgery and associated cement augmentation are scarce.
As far as we are concerned, this is the first case in the literature of a re-revision surgery of an extracapsular hip fracture due to a three months postoperative cut-through and a posterior cement leakage into the hip joint after TFN-A cement augmentation and spiral lamina replacement with the need of a posterolateral approach for removal.
使用髓内颈骨干钉（贯穿）进行切开复位内固定（CRIF）后，螺旋板或螺钉在关节内移位是最常见的术后并发症之一。我们报告一例患者，在进行TFN-A骨水泥强化和螺旋板置换术后出现贯穿及骨水泥漏入髋关节。
一名83岁男性，在术后第三个月左髋关节囊外骨折行CRIF后发生贯穿。计划进行翻修手术，包括螺旋板置换和骨水泥强化。术后即刻X线片证实骨水泥漏入髋关节，遂进行新的干预，取出异物。
患者临床进展良好，无功能受限或疼痛。在常规术后影像学检查中，与术后即刻相比未观察到差异。
目前关于植入物翻修手术及相关骨水泥强化的文献较少。
就我们所知，这是文献中首例因术后三个月出现贯穿及TFN-A骨水泥强化和螺旋板置换后骨水泥向后漏入髋关节而需采用后外侧入路进行取出的髋关节囊外骨折再次翻修手术病例。
