Broken guidewire intramedullary: what to do now?

Abstract

Instrument breakage during orthopaedic procedures is relatively uncommon, but it remains a challenging problem to orthopaedic surgeons. We report a case of a broken guidewire during intramedullary nail fixation of a proximal femur fracture with subtrochanteric extension. We also report a simple yet effective technique for removal of a broken guidewire from the medulla of the proximal femur without causing much iatrogenic trauma.

Retrieval of broken intra-medullary guide wire in femoral shaft fracture: A case report and surgical technique

“…Broken Hardware removal is a nightmare during surgery for any orthopedic surgeon. There are multiple reported instances of broken instrument or implants which needed some expertise for removal [ [1] , [2] , [3] , [4] , [5] , [6] ]. Hardware in soft tissue can be easily retrieved, however the scenario is different when it is embedded in the bone, especially if it is intramedullary.…”

“…We had a different situation while managing a patient with fracture shaft of femur, wherein the initial guide wire used for making entry point broke during reaming and had to retrieved from the fracture site. Given the shape and a hollow nature of intramedullary implant and options to hold it can be retrieved using different techniques, but a solid and small intramedullary implant retrieval can pose problems difficult to tackle while extracting it [ 3 , 4 ]. The location of the stuck hardware can eventually not only make the reaming troublesome, but also not allow the intramedullary implant to gain access of the canal to fix the fracture.…”