Key result
Postoperative intrapelvic migration of a lag screw occurred without trauma after intramedullary nailing for an intertrochanteric femoral fracture, requiring revision with total hip arthroplasty.
Case Report (n=1)
Highlights the importance of optimal fracture reduction and precise insertion of the set screw to prevent medial migration of the lag screw during intramedullary nailing.
Surgeons should remain vigilant for atraumatic lag screw migration after femoral nailing; this case leaves open optimal prevention strategies.
Internal fixation with intramedullary devices has gained popularity for the treatment of intertrochanteric femoral fractures, which are common injuries in the elderly. The most common complications are lag screw cut out from the femoral head and femoral fracture at the distal tip of the nail. We report here a rare complication of postoperative lag screw migration into the pelvis with no trauma. The patient was subsequently treated with lag screw removal and revision surgery with total hip arthroplasty. This case demonstrated that optimal fracture reduction and positioning of the lag screw are the most important surgical steps for decreasing the risk of medial migration of the lag screw. Furthermore, to prevent complications, careful attention should be paid to subsequent steps such as precise insertion of the set screw.
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Takasago et al. (2014) conducted a case report in Intertrochanteric femoral fracture (n=1). Intramedullary nailing with lag screw was evaluated on Postoperative lag screw migration into the pelvis. Postoperative intrapelvic migration of a lag screw occurred without trauma after intramedullary nailing for an intertrochanteric femoral fracture, requiring revision with total hip arthroplasty.
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