Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of ...Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac- ture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotat- ing arotmd the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the bro-ken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixa- tion was easily finished. The patient had an uneventful re- covery without avascular necrosis of femoral head or non- union of the fracture at one year＇s follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.展开更多
文摘Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw （DHS）. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac- ture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotat- ing arotmd the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the bro-ken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixa- tion was easily finished. The patient had an uneventful re- covery without avascular necrosis of femoral head or non- union of the fracture at one year＇s follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.
