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关节镜抓钳取出髋关节内断钉-技术要点及文献复习

Broken pin removal from hip joint using arthroscopic grasper - A technical note and review of literature.

机构信息

Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran.

Students' Scientific Research Center (SSRC), Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Injury. 2022 Nov;53(11):3853-3857. doi: 10.1016/j.injury.2022.08.054. Epub 2022 Aug 27.

Abstract

Guidewire breakage during a surgical procedure is uncommon but still challenging for orthopedic surgeons. Due to the potential for harmful complications, surgeons prefer to remove broken wires near the joint surface or neurovascular bundle in the hip region. Due to the depth of the location, the retrieval procedure is arduous, time-consuming, and potentially dangerous. This study describes a case of a sub-capital femoral neck fracture that was fixed with a cannulated screw. However, three years later, the distal portion of the guidewire broke and migrated into the hip joint, where it became entrapped. This study describes a method for removing a broken wire from the hip region and a relevant literature review. In brief, initially, we untightened the screw and removed it. Afterward, the broken wire was reached by reaming in the direction of the screw. Ultimately, we advanced the arthroscopic grasper to the broken wire for removal under fluoroscopic guidance. The study's findings indicate that this method could provide a promising outcome with minimal complications.

摘要

在手术过程中导丝断裂并不常见,但仍然对骨科医生构成挑战。由于存在潜在的有害并发症,外科医生更愿意在髋关节区域接近关节面或神经血管束的位置取出断裂的导丝。由于位置较深,取出过程艰巨、耗时且具有潜在危险。本研究描述了一例股骨颈骨折采用空心螺钉固定的病例。然而,三年后,导丝的远端断裂并迁移到髋关节,卡在那里。本研究描述了一种从髋关节取出断裂导丝的方法,并进行了相关文献复习。简而言之,我们首先松开螺钉并将其取出。然后,通过向螺钉方向扩孔来触及断裂的导丝。最终,我们在透视引导下将关节镜抓钳推进到断裂的导丝处以将其取出。该研究结果表明,这种方法可能具有最小的并发症并提供有前景的结果。

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