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Medial Migration of a Broken Trochanteric Cable

机译:股骨转子电缆的内侧迁移

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Background. Cerclage wires or cables are commonly being used in hip reconstruction procedures like primary (especially in patients with developmental hip dysplasia) or revision arthroplasty. Local or distant migration of a broken cable or wire is a complication that might lead to devastating situations depending on the route of migration. Case Presentation. We report a case of a 40-year-old female who underwent bilateral total hip arthroplasty surgery due to bilateral developmental hip dysplasia. Trochanteric osteotomy was needed in her right hip to advance trochanter major distally. Trochanteric fixation was achieved by a cerclage cable system. Four years after the surgery, the patient referred to the hospital with a prominence and pain in her right inguinal area. Radiographies revealed medial migration of a broken trochanteric cable part. The possible route of the cable was through medial adductor muscles, posterior to the femoral neurovascular bundle and anterior to the sciatic nerve. Both migrated and remaining parts of the cable were extracted under general anesthesia. Conclusion. Broken cables should be followed carefully due to their sharpness and possible serious complications secondary to distant migration. Extraction might be inevitable in case of a close relation with neurovascular structures.
机译:背景。环扎电线或电缆通常用于髋关节重建手术中,例如原发性(尤其是发育性髋关节发育不良的患者)或翻修置换术。折断的电缆或电线的局部或远距离迁移是一种复杂情况,根据迁移途径的不同,可能会导致灾难性的情况。案例介绍。我们报告了一例40岁的女性,由于双侧发育性髋关节发育不良而接受了双侧全髋关节置换术。她的右臀部需要进行转子粗隆截骨术,以向远侧推进转子粗隆。转子环固定是通过环扎电缆系统实现的。手术四年后,患者因腹股沟右侧突出和疼痛而转诊至医院。 X线片显示股骨粗隆电缆部分的内侧移位。电缆的可能路径是通过内侧内收肌,在股神经血管束后,坐骨神经前。在全身麻醉下取出电缆的迁移部分和其余部分。结论。由于电缆的锋利度以及远距离迁移可能引起的严重并发症,应小心处理断裂的电缆。与神经血管结构密切相关的情况下,拔牙可能是不可避免的。

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