Intravesical Migration of a Screw during Hip Osteosynthesis: A Case Report

Wadia Montassar, Ziadi Hamdi, Lahssini Wael, Mohamed Amine Bennour
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Abstract

The incidence of fractures of the upper extremity of the femur continues to increase as the population ages. Dynamic hip screw (DHS) is the treatment of choice for stable fractures. We report the case of an 80-year-old man with no notable pathological history presenting with a pertrochanteric fracture. Intraoperatively, the cephalic screw migrated unexpectedly into the pelvis. Several attempts were made to remove it, but the screw had penetrated deep into the pelvis, making removal impossible through the femoral neck. An emergency abdominal CT scan was performed showing that the screw had penetrated into the bladder. The urological surgeon was called in to remove the screw via a medial abdominal approach, which was fnally removed without any further complications. Intravesical migration of a DHS screw is a rare complication. Compliance with the DHS surgical technique, especially in very old osteoporotic patients, can avoid this complication.
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髋关节植骨术中螺钉的膀胱内移位一例报告
随着人口老龄化,股骨上肢骨折的发生率持续增加。动态髋螺钉(DHS)是治疗稳定性骨折的首选方法。我们报告的情况下,80岁的男子没有明显的病理史,提出了股骨粗隆骨折。术中,头侧螺钉意外移位到骨盆内。多次尝试将其取出,但螺钉已深入骨盆,无法通过股骨颈取出。急诊腹部CT扫描显示螺钉已穿透膀胱。泌尿外科医生被叫来通过腹部内侧入路取出螺钉,最终取出螺钉,没有任何进一步的并发症。DHS螺钉膀胱内移位是一种罕见的并发症。遵循DHS手术技术,特别是非常老的骨质疏松患者,可以避免这种并发症。
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