Yamada Atsuhisa, Yasui Tetsuro, Miki Yuji, Nakamura Shigeru
Department of Orthopaedic Surgery, Teikyo University Mizunokuchi Hospital, Kanagawa, Japan.
J Orthop Case Rep. 2022 Dec;12(12):86-89. doi: 10.13107/jocr.2022.v12.i12.3476.
Hansson Pinloc system consists of three pins locking into a plate. In biomechanical trials, the novel plate design with its pin configuration enhanced torsional stability. Hansson Pinloc has been used for femoral neck fracture in some countries including Sweden and Japan. Recently, the outcome of a randomized clinical study comparing Hansson Pinloc and conventional Hansson pins was published. However, subtrochanteric fracture after internal fixation using Hansson Pinloc has not been reported in the English literature including the above report. Only several Japanese literatures reported some cases with this post-operative complication. We present a case with subtrochanteric fracture after internal fixation using Hansson Pinloc.
Subtrochanteric fractures after internal fixation of femoral neck fractures are rare but severe complications. We present our experience of this complication after internal fixation using Hansson Pinloc system which is a new design implant for femoral neck fracture. A 67-year-old woman was diagnosed with a femoral neck fracture of Garden stage I after a fall. She underwent closed reduction and internal fixation using Hansson Pinloc system. At 4 weeks after surgery, she suffered subtrochanteric fracture without any episode of trauma. The patient underwent removal of the instrumentation and internal fixation with a long femoral nail. We get in trouble with removing Hansson Pinloc system due to secondary fracture, and of bone defect. 9 weeks after the second surgery, the patient could get bone union and walk using double T-canes.
Surgeons should be cognizant of this post-operative complication before using this system. In osteosynthesis of the femoral neck fracture using Hansson Pinloc, we should keep in mind that subtrochanteric fracture is a possible post-operative complication.
汉森针板系统由三根锁定在钢板上的针组成。在生物力学试验中，这种具有针配置的新型钢板设计增强了扭转稳定性。汉森针板系统已在包括瑞典和日本在内的一些国家用于股骨颈骨折。最近，一项比较汉森针板系统和传统汉森针的随机临床研究结果已发表。然而，包括上述报告在内的英文文献中尚未报道使用汉森针板系统内固定后发生的转子下骨折。只有几篇日本文献报道了一些有这种术后并发症的病例。我们报告一例使用汉森针板系统内固定后发生转子下骨折的病例。
股骨颈骨折内固定后发生转子下骨折是一种罕见但严重的并发症。我们介绍了使用汉森针板系统（一种用于股骨颈骨折的新型植入物）内固定后出现这种并发症的经验。一名67岁女性在跌倒后被诊断为Garden I期股骨颈骨折。她接受了汉森针板系统的闭合复位和内固定。术后4周，她在没有任何外伤的情况下发生了转子下骨折。患者接受了内固定器械取出及股骨长钉内固定。由于继发骨折和骨缺损，我们在取出汉森针板系统时遇到了困难。二次手术后9周，患者实现了骨愈合，可使用双T形拐杖行走。
外科医生在使用该系统之前应认识到这种术后并发症。在使用汉森针板系统进行股骨颈骨折的接骨术中，我们应牢记转子下骨折是一种可能的术后并发症。
