微创内固定不拔除股骨颈内钉1例

Q4 Medicine

Trauma Case Reports Pub Date : 2025-10-02 DOI:10.1016/j.tcr.2025.101252

Edgar Barros , Carlos Ballesteros , Eduardo Noboa , Carlos Peñaherrera , Francisco Endara , Paul Vaca Perez , Diego Michilena , Alejandro Barros Castro

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引用次数: 0

摘要

我们报告一例53岁的女性患者，10多年前从站立高度低能坠落后植入髓内钉（IMN），导致经颈股内钉周围骨折。由于拔钉的风险，如医源性骨折和软组织损伤，原有的植入物限制了传统的手术选择。在牵引台辅助下进行闭合复位，然后用中空螺钉内固定倒三角形结构，保留原有的种植体并避免手术并发症。临床和功能随访显示恢复满意。6周时，Harris髋关节评分（HHS）和Oxford髋关节评分（OHS）显示中度恢复，1年后逐渐改善达到优异评分（HHS: 96, OHS: 46）。本病例强调了空心螺钉作为治疗种植体周围经颈椎骨折的微创和有效策略的可行性，使患者获益最大化，同时将手术风险降至最低。

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Minimally invasive fixation of a peri-implant femoral neck fracture without nail removal: A case report

We present the case of a 53-year-old female patient with a peri-implant transcervical femoral fracture associated with an intramedullary nail (IMN) implanted over 10 years ago following a low-energy fall from standing height. The preexisting implant constrained traditional surgical options due to the risks associated with nail removal, such as iatrogenic fractures and soft tissue damage. Closed reduction assisted by a traction table was performed, followed by internal fixation with cannulated screws in an inverted triangular configuration, preserving the preexisting implant and avoiding surgical complications.

Clinical and functional follow-up demonstrated a satisfactory recovery. At 6 weeks, the Harris Hip Score (HHS) and Oxford Hip Score (OHS) indicated moderate recovery, with progressive improvement reaching excellent scores at 1 year (HHS: 96, OHS: 46). This case highlights the feasibility of cannulated screws as a minimally invasive and effective strategy for peri-implant transcervical fractures, maximizing patient benefits while minimizing surgical risks.

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.