Intra-articular fragment extrusion during tibial intramedullary nailing

Rodger, Mike; Atkins, R. M.

doi:10.1016/j.injury.2007.10.009

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…However, both cases shared the same problem - control X-rays did not involve the joint distal to the nail. To continue, in two of five cases, joint penetration was detected in postoperative X-rays, and only in one case, a complication was detected before the end of the surgery [ 10 , 12 ]. In our case, the knee joint was involved in control films, but they were interpreted as normal and only extreme pain of the knee forced the physician to re-evaluate the X-rays.…”

Section: Discussionmentioning

confidence: 99%

“…Joint perforation by bone fragment during nail insertion is an extremely unique complication. At the time of writing, a PubMed database search using the terms complication AND nail AND fragment AND bone AND joint revealed five cases: three cases of femoral bone fragment penetration to the knee joint, one case of tibial fragment penetration to the ankle joint, and one case of ankle joint perforation by bone fragment [10][11][12]. To our knowledge, it is the first described case of knee joint arthrodesis and complete tibial condyle perforation by femoral bone fragment during nailing of an intertrochanteric fracture, which led to posttraumatic arthrosis and total knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

Masionis¹,

Porvaneckas²,

Uvarovas³

et al. 2022

Cureus

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Intramedullary nailing is the preferred treatment method in tibial, femoral shaft, and sub-or intertrochanteric fractures. Despite good results, a number of complications have been well-characterized. Joint perforation by bone fragment during nail insertion is one such complication.We report an eventful case of a 63-year-old female patient who presented with an intertrochanteric fracture. Osteosynthesis with a short proximal femoral nail was complicated by a well-known and recognized on-time complication -an iatrogenic fracture of the femoral shaft. However, it was further complicated by knee arthrodesis by a bone fragment when a long nail was inserted. The bone fragment not only "closed" the knee joint, but fractured the medial tibial condyle and protruded into the medial soft tissues of the joint. This misfortune was not recognized intraoperatively and led to revision surgery in the short term and joint posttraumatic arthrosis with resultant total knee replacement in the long term.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

Masionis¹,

Porvaneckas²,

Uvarovas³

et al. 2022

Cureus

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“…PubMed duomenų paieškos bazėje rastos tik trys publikacijos, kuriose aprašomi pavieniai klinikiniai atvejai. M. Rodger ir R. Atkins aprašė kaulinio fragmento ekstruziją į blauzdinį pėdos sąnarį blauzdikaulio intramedulinės osteosintezės metu [6]. Skeveldra buvo pastebėta pooperacinėse rentgenogramose ir pašalinta per 48 valandas.…”

Section: Diskusijaunclassified

Kelio Sąnario Penetracija Šlaunikaulio Diafizės Skeveldra Intramedulinės Osteosintezės Metu. Klinikinis Atvejis

Jodinskas¹,

Masionis²,

Porvaneckas³

et al. 2020

Health Sciences

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Šlaunikaulio artimojo galo lūžiai – dažna vyresnio amžiaus žmonių traumų pasekmė. Tik ankstyvas operacinis gydymas gali sumažinti komplikacijų riziką ir mirštamumą, tačiau kiekvienas gydymo metodas turi ne tik pranašumų, bet ir specifinių komplikacijų. Straipsnyje pristatomas ypač retos intraoperacinės komplikacijos klinikinis atvejis – kelio sąnario penetracija šlaunikaulio diafizės skeveldra intramedulinės osteosintezės metu. Ši komplikacija labai reta, o įvykusi – pavėluotai diagnozuojama. Atvejo analizės rezultatai parodė, kad intramedulinės osteositnezės, atliekamos rentgeno kontrolėje, metu būtina nuodugniai įvertinti ne tik lūžgalių ir konstrukcijų padėtis, bet ir šalia esančius sąnarius.

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“…1,4,6, [13][14][15] Prior case reports have noted intraoperative complications of incarcerated cortical fragments in the medullary canal resulting in impassable guidewires and reamers, intra-articular penetration of the fragment, and intra-articular advancement of the guidewire. [16][17][18][19][20][21][22] To the authors' knowledge, a specific report on how to remove an incarcerated cortical fragment has not been presented in the orthopedic literature. The authors present a case in which 2 incarcerated cortical fragments impeded passage of the reamer and induced deformity at the fracture site during the reaming.…”

mentioning

confidence: 99%

Incarcerated Cortical Fragments in Intramedullary Nailing

Eastman¹,

Firoozabadi²,

Cook³

et al. 2016

Orthopedics

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In fractures with varying degrees of comminution, it is possible for cortical bone fragments to become entrapped within the intramedullary canal. There have been prior case reports on complications associated with incarcerated fragments; however, there has been no proposed solution. The current case shows how 2 cortical fragments in the distal segment of a comminuted femur fracture impeded passage of the intramedullary reamer and induced deformity at the fracture site during the reaming. The authors describe a simple method of retrieval without having to formally open the fracture site. Recognizing the presence of an incarcerated fragment and appropriately managing it intraoperatively allows for fracture fixation to occur uneventfully. [Orthopedics. 2016; 39(3):e582-e586.].

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Intra-articular fragment extrusion during tibial intramedullary nailing

Cited by 3 publications

References 19 publications

From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

Kelio Sąnario Penetracija Šlaunikaulio Diafizės Skeveldra Intramedulinės Osteosintezės Metu. Klinikinis Atvejis

Incarcerated Cortical Fragments in Intramedullary Nailing

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