Volume 7, Issue 5, October 2019, Page: 128-131
A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation
Wenrui Wu, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Simin Luo, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Tengfeng Zhuang, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Ning Liu, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Zhengang Zha, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Received: Jul. 8, 2019;       Accepted: Aug. 10, 2019;       Published: Aug. 26, 2019
DOI: 10.11648/j.js.20190705.13      View  41      Downloads  6
Abstract
Context: Cannulated instruments are usually used while operating around the hip joint for fractures. For example, femoral neck fracture, intertrochanteric fracture, etc. Perioperative instrument breakage such as kirschner wires and guide pins is not infrequent. The fragment of instruments must be removed in order to avoid injury some important organizations. If the fragment further migrate to the acetabulum can result in serious or fatal complications. Removing a broken guide-wire is difficult and challenging even for experienced surgeons. Case Report: We present a simple and useful method to remove the broken guide-wire in the hip joint just using cannulated reamer to ream over the guide wire under the C-arm image intensifier. At first, confirm the cannulated reamer to sight the broken end of the wire, and passed through the broken guide-wire. Then, further reaming with low speed rotation till the beginning of the reamer encased the broken guide-wire. The reamer was withdrawn a few millimeters, after confirmation of the broken guide-wire dislodgment and firmly engaged within the drill lumen by the C-arm image intensifier. Reverse the guide-wire slightly with the reamer through the Proximal Femoral Nail hole. Conclusions: With this method, the authors were able to remove the broken guide wire easily in a few minutes.
Keywords
Broken Guide-wire, Removing, Hip Joint, Cannulated Reamer
To cite this article
Wenrui Wu, Simin Luo, Tengfeng Zhuang, Ning Liu, Zhengang Zha, A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation, Journal of Surgery. Vol. 7, No. 5, 2019, pp. 128-131. doi: 10.11648/j.js.20190705.13
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Saini U C, Gopinathan N R, Aggarwal S, et al. Intrapelvic Protrusion of a Broken Guide Wire Fragment during Fixation of a Femoral Neck Fracture. The archives of bone and joint surgery. 2018, 6 (2): 155-156.
[2]
Salunke, A. A., Menon, P. H., Nambi, G. I, et al. Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report. 2015. Sao Paulo Medical Journal, 133 (6), 531–534.
[3]
Pichler W, Mazzurana P, Clement H, et al. Frequency of instrument breakage during orthopaedic procedures and its effects on patients. J Bone Joint Surg Am 90: 2652–2654, 2008.
[4]
Sen RK, Tripathy SK, Aggarwal S, et al. Broken Kirschner or guide-wire retrieval: a report of 4 cases. Hip Int 20: 551–554, 2010.
[5]
Sharma H, Chauhan M, Maini L. A technique to remove a broken guide wire transfixing the hip joint. Acta Orthop Belg. 2008; 74 (5): 683-685.
[6]
Sayegh FE, Tsintzas D, Kapetanos GA. Intrapelvic migration of a guide pin during fixation of a hip fracture: who and what is to blame? Acta Orthop Belg. 2005; 71 (2): 239-241.
[7]
Sen RK, Tripathy SK, Aggarwal S, et al. Broken Kirschner or guide-wire retrieval: a report of 4 cases. Hip Int 2010; 20 (4): 551-4.
[8]
Kumar A, Jain A, Saurabh S, et al. Technical tip for removal of broken cephalomedullary reamer tip in cases of proximal femoral nailing. Journal of clinical orthopaedics and trauma. 2019.
[9]
Arora S, Maini L, Aggarwal V, et al. Broken guide-wire protruding into the hip joint: A bone endoscopicassisted retrieval method. Indian J Orthop 2012; 46: 109-12.
[10]
Saurabh Jain, Abhishek Pathak, Rajeev Kant Pandey. Retrieval of a broken guide-wire transfixing the hip through the proximal femoral nail hole. Chinese Journal of Traumatology. 50. 2014; 17 (1): 50-53.
[11]
Koval KJ, Zuckerman JD. Hip fractures. A practical guide to management [M]. New York: Springer, 2000: 20-1.
[12]
Chouhan D K, Sharma S. "Push back" technique: A simple method to remove broken drill bit from the proximal femur. World journal of orthopedics. 2015, 6 (10): 847-849.
[13]
Mishra P, Gautam VK. Broken guide wire with intrapelvic protrusion: a technique for removal. Injury. 2004; 35 (12): 1324-1326.
[14]
Peivandi MT, Kachooei AR, Nazemian Z. New method to remove a broken guide pin in the hip joint. Orthopedics. 2011; 34 (10): e685-7.
Browse journals by subject