Intra-operative femoral neck fracture during attempted dislocation of a reduced hemi-arthroplasty
Ling, S.K.K.; Ma, C.M.; Lui, T.H.
Journal of the Medical Association of Thailand 98(5): 520-522
2015
ISSN/ISBN: 0125-2208 PMID: 26058283 Document Number: 16617
Fragility hip fractures are increasingly common and hemiarthroplasty is one of the standard treatments. Although a common surgery, it should be performed with great caution because of the poor premorbid and bone quality in this demographic. Intra-operative fractures can occur while attempting press fit of the femoral implant. However; vigilance often steps down once the implant is secured and the hip reduced. This case report reminds surgeons that a large amount of torque can be transmitted during intra-operative positioning, such as during an attempt of hip dislocation. This torque, in addition to the risk factor of osteoporotic bone, can result in iatrogenic fractures. Published literature regarding management of an intra-operative fracture while the prosthetic hip is still reduced is lacking. The authors propose that temporary prophylactic cerclage wiring is a prudent and safe procedure prior to hip dislocation.
Document emailed within 1 workday
