López Reyes Alberto^1,2, Gutiérrez Rojas Saúl^1,2, Vilo Ulloa Francisco^1,2, Cárdenas Serón Juan^1,2 and Gatica Carbonell Javier^1,2

¹Pelvis Hip Unit, Department of Traumatology and Orthopedics, Hospital Barros Luco Trudeau, San Miguel, Santiago de Chile ²University of Santiago, Chile (USACH). Barros Luco Hospital Clinical Campus. Adult Orthopedics and Traumatology

*Corresponding Author: López Reyes Alberto, Pelvis Hip Unit, Department of Traumatology and Orthopedics, Barros Luco Trudeau Hospital, San Miguel, Santiago, de Chile.

Received: June 27, 2023; Published: July 28, 2023

Abstract

The use of intramedullary devices has increased, representing the first treatment option in pertrochanteric fractures. The most common mechanism of osteosynthesis failure is the cut out of the cephalic screw with secondary varus collapse of the femoral neck-shaft angle. We present a case of osteosynthesis failure after hip fracture with migration of the cephalic screw of a gamma 3® nail, with the rare complication of migration of the nail towards the pelvis (cut in). In this case, we opted to perform a rescue arthroplasty once the osteosynthesis material was removed. Achieving a good result in terms of pain relief and recovering the functionality of our patient.

Conclusion: Calcaneal Fractures; Minimally Invasive; Sinus Tarsi Approach.

Keywords: Cut In; Osteosynthesis Failure; Salvage Arthroplasty

References

1. EMZ Morsi., et al. “The use of standard cemented femoral stems in total hip replacement after failed internal fixation of intertrochanteric femoral fractures”. The Journal of Arthroplasty 9 (2020): 2525-2528.
2. Díaz Ledezma C., et al. “Hip fractures in the elderly Chilean population: a projection for 2030”. Archives of Osteoporosis 15 (2020): 116.
3. Ioannis Papaioannou., et al. “A unique cause of gamma 3 cut out: A case report and literature review”. Journal of Clinical Orthopaedics and Trauma 13 (2021): 92-94.
4. Mao W., et al. “Comparison of Baumgaertner and Chang reduction quality criteria for the assessment of trochanteric fractures”. Bone and Joint Research 8 (2019): 502-508.
5. Baumgaertner MR., et al. “The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip”. The Journal of Bone and Joint Surgery. American Volume 77 (1995): 1058-1064.
6. De Bruijn K., et al. “Reliability of predictors for screw cutout in intertrochanteric hip fractures”. The Journal of Bone and Joint Surgery. American Volume 94 (2012): 1266-1272.
7. Cleveland M., et al. “A ten year analysis of intertrochanteric fractures of the femur”. The Journal of Bone and Joint Surgery. American Volume 41-A (1959): 1399-1408.
8. Haidukewych GJ and Berry “Hip arthroplasty for salvage of failed treatment of intertrochanteric fractures”. The Journal of Bone and Joint Surgery. American Volume 85 (2003): 899-904.
9. Enocson A., et al. “Hip arthroplasty after failed fixation of trochanteric and subtrochanteric fractures”. Acta Orthopaedica 5 (2012): 493-498.
10. Cuervas-Mons M., et al. “Disassembly by cut-out effect in the interlocking of pertrochanteric femur fractures: What is the rescue treatment of choice?” Revista Española de Cirugía Ortopédica y Traumatología (2014).
11. Ciufo , et al. “Risk Factors associated with cephalomedullary nail cutout in the treatment of trochanteric hip fractures”. Journal of Orthopaedics and Traumatology 31.11 (2017).
12. Jacob J., et al. “Decision making in the management of extracapsular fractures of the proximal femur - is the dynamic hip screw the prevailing gold standard?” The open Orthopaedics Journal7-M5 (2017): 1213-1217.
13. Socci , et al. “Implant options for the treatment of intertrochanteric fractures of the hip”. Bone Joint Journal 99-B (2017): 128-133.
14. Wadhwani , et al. “Not everything is cut out: reclassification of the mechanical complications of the head screw of the intramedullary nail”. Spanish Journal of Osteoarticular Surgery 280.54 (2019): 136-142.
15. Haidukewych GJ. “Intertrochanteric fractures: ten tips to improve results”. The Journal of Bone and Joint Surgery. American Volume 91A (2009): 712-719.

Citation

Citation: López Reyes Alberto.,et al. “Rescue Arthroplasty After Cut in Cephalomedullary Hip Nail".Acta Scientific Orthopaedics 6.8 (2023): 108-112.

Copyright

Copyright: © 2023 López Reyes Alberto.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.