Arthroscopic Removal of a Screwdriver Fragment in a Dog 6 Years after Femoral Fracture Repair

VCOT Open Pub Date : 2020-01-01 DOI:10.1055/s-0040-1709451
M. Petazzoni
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引用次数: 1

Abstract

Abstract Objective The aim of this study was to report an unusual case of an iatrogenic foreign body within the stifle joint, removed 6 years after distal femoral fracture repair in a small dog. Acute lameness was caused by a migrating screwdriver fragment, which had been lost during initial fracture repair and which did not cause clinical signs for years until dislodged inside the joint. Case Report A male Jack Russell, 7 years of age, underwent plate and screws fixation to treat a Salter-Harris type I fracture at the age of 9 months. Seven months after surgery, partial implant removal was performed. Six years after fracture repair, the dog presented for a non-weight-bearing lameness and pain on the previously operated stifle joint, which occurred suddenly while walking on the leash. Radiographs revealed a small intra-articular metallic radiodense foreign body. Arthroscopy was used to remove the migrating broken-tip of a screwdriver from the medial aspect of the tibiofemoral joint. Retrieving the foreign body led to the immediate resolution of clinical signs without complications. Conclusion By reporting this case of a forgotten foreign body retained inside a stifle joint for 6 years, we aim to illustrate the potential risk of leaving a piece of metal inside the body. A high index of suspicion for such complications should be kept a long time after surgery. Arthroscopy was a useful first-line tool for efficiently and mini-invasively treating this unusual problem.
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犬股骨骨折修复6年后关节镜下螺丝刀碎片去除
摘要目的报告一例罕见的犬股远端骨折修复后6年取出的膝关节内医源性异物。急性跛行是由一个迁移的螺丝刀碎片引起的,该碎片在最初的骨折修复过程中丢失,多年来没有引起临床症状,直到在关节内移位。病例报告一名7岁的雄性杰克罗素犬,在9个月大时接受钢板和螺钉固定治疗Salter-Harris I型骨折。术后7个月,进行部分种植体移除。骨折修复六年后,狗出现了非负重的跛行和先前手术的膝关节疼痛,这是在牵着皮带走路时突然发生的。x线片显示一个小的关节内金属放射性致密异物。关节镜用于从胫股关节内侧移除迁移的螺丝刀断裂尖端。取出异物可立即消除临床症状,无并发症。结论:通过报告这个被遗忘的异物在膝关节内保留了6年的病例,我们的目的是说明在体内留下一块金属的潜在风险。术后应长期保持对此类并发症的高度怀疑。关节镜检查是有效微创治疗这种罕见疾病的一线工具。
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