Journal of Surgery

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A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation

Received: 08 July 2019    Accepted: 10 August 2019    Published: 26 August 2019
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Abstract

Context: Cannulated instruments are usually used while operating around the hip joint for fractures. For example, femoral neck fracture, intertrochanteric fracture, etc. Perioperative instrument breakage such as kirschner wires and guide pins is not infrequent. The fragment of instruments must be removed in order to avoid injury some important organizations. If the fragment further migrate to the acetabulum can result in serious or fatal complications. Removing a broken guide-wire is difficult and challenging even for experienced surgeons. Case Report: We present a simple and useful method to remove the broken guide-wire in the hip joint just using cannulated reamer to ream over the guide wire under the C-arm image intensifier. At first, confirm the cannulated reamer to sight the broken end of the wire, and passed through the broken guide-wire. Then, further reaming with low speed rotation till the beginning of the reamer encased the broken guide-wire. The reamer was withdrawn a few millimeters, after confirmation of the broken guide-wire dislodgment and firmly engaged within the drill lumen by the C-arm image intensifier. Reverse the guide-wire slightly with the reamer through the Proximal Femoral Nail hole. Conclusions: With this method, the authors were able to remove the broken guide wire easily in a few minutes.

DOI 10.11648/j.js.20190705.13
Published in Journal of Surgery (Volume 7, Issue 5, October 2019)
Page(s) 128-131
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Broken Guide-wire, Removing, Hip Joint, Cannulated Reamer

References
[1] Saini U C, Gopinathan N R, Aggarwal S, et al. Intrapelvic Protrusion of a Broken Guide Wire Fragment during Fixation of a Femoral Neck Fracture. The archives of bone and joint surgery. 2018, 6 (2): 155-156.
[2] Salunke, A. A., Menon, P. H., Nambi, G. I, et al. Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report. 2015. Sao Paulo Medical Journal, 133 (6), 531–534.
[3] Pichler W, Mazzurana P, Clement H, et al. Frequency of instrument breakage during orthopaedic procedures and its effects on patients. J Bone Joint Surg Am 90: 2652–2654, 2008.
[4] Sen RK, Tripathy SK, Aggarwal S, et al. Broken Kirschner or guide-wire retrieval: a report of 4 cases. Hip Int 20: 551–554, 2010.
[5] Sharma H, Chauhan M, Maini L. A technique to remove a broken guide wire transfixing the hip joint. Acta Orthop Belg. 2008; 74 (5): 683-685.
[6] Sayegh FE, Tsintzas D, Kapetanos GA. Intrapelvic migration of a guide pin during fixation of a hip fracture: who and what is to blame? Acta Orthop Belg. 2005; 71 (2): 239-241.
[7] Sen RK, Tripathy SK, Aggarwal S, et al. Broken Kirschner or guide-wire retrieval: a report of 4 cases. Hip Int 2010; 20 (4): 551-4.
[8] Kumar A, Jain A, Saurabh S, et al. Technical tip for removal of broken cephalomedullary reamer tip in cases of proximal femoral nailing. Journal of clinical orthopaedics and trauma. 2019.
[9] Arora S, Maini L, Aggarwal V, et al. Broken guide-wire protruding into the hip joint: A bone endoscopicassisted retrieval method. Indian J Orthop 2012; 46: 109-12.
[10] Saurabh Jain, Abhishek Pathak, Rajeev Kant Pandey. Retrieval of a broken guide-wire transfixing the hip through the proximal femoral nail hole. Chinese Journal of Traumatology. 50. 2014; 17 (1): 50-53.
[11] Koval KJ, Zuckerman JD. Hip fractures. A practical guide to management [M]. New York: Springer, 2000: 20-1.
[12] Chouhan D K, Sharma S. "Push back" technique: A simple method to remove broken drill bit from the proximal femur. World journal of orthopedics. 2015, 6 (10): 847-849.
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[14] Peivandi MT, Kachooei AR, Nazemian Z. New method to remove a broken guide pin in the hip joint. Orthopedics. 2011; 34 (10): e685-7.
Author Information
  • Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

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  • APA Style

    Wenrui Wu, Simin Luo, Tengfeng Zhuang, Ning Liu, Zhengang Zha. (2019). A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation. Journal of Surgery, 7(5), 128-131. https://doi.org/10.11648/j.js.20190705.13

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    ACS Style

    Wenrui Wu; Simin Luo; Tengfeng Zhuang; Ning Liu; Zhengang Zha. A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation. J. Surg. 2019, 7(5), 128-131. doi: 10.11648/j.js.20190705.13

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    AMA Style

    Wenrui Wu, Simin Luo, Tengfeng Zhuang, Ning Liu, Zhengang Zha. A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation. J Surg. 2019;7(5):128-131. doi: 10.11648/j.js.20190705.13

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  • @article{10.11648/j.js.20190705.13,
      author = {Wenrui Wu and Simin Luo and Tengfeng Zhuang and Ning Liu and Zhengang Zha},
      title = {A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation},
      journal = {Journal of Surgery},
      volume = {7},
      number = {5},
      pages = {128-131},
      doi = {10.11648/j.js.20190705.13},
      url = {https://doi.org/10.11648/j.js.20190705.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20190705.13},
      abstract = {Context: Cannulated instruments are usually used while operating around the hip joint for fractures. For example, femoral neck fracture, intertrochanteric fracture, etc. Perioperative instrument breakage such as kirschner wires and guide pins is not infrequent. The fragment of instruments must be removed in order to avoid injury some important organizations. If the fragment further migrate to the acetabulum can result in serious or fatal complications. Removing a broken guide-wire is difficult and challenging even for experienced surgeons. Case Report: We present a simple and useful method to remove the broken guide-wire in the hip joint just using cannulated reamer to ream over the guide wire under the C-arm image intensifier. At first, confirm the cannulated reamer to sight the broken end of the wire, and passed through the broken guide-wire. Then, further reaming with low speed rotation till the beginning of the reamer encased the broken guide-wire. The reamer was withdrawn a few millimeters, after confirmation of the broken guide-wire dislodgment and firmly engaged within the drill lumen by the C-arm image intensifier. Reverse the guide-wire slightly with the reamer through the Proximal Femoral Nail hole. Conclusions: With this method, the authors were able to remove the broken guide wire easily in a few minutes.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - A Useful Technique for Removing a Broken Guide-wire in the Femoral Neck Through the Proximal Femoral Nail Hole During Operation
    AU  - Wenrui Wu
    AU  - Simin Luo
    AU  - Tengfeng Zhuang
    AU  - Ning Liu
    AU  - Zhengang Zha
    Y1  - 2019/08/26
    PY  - 2019
    N1  - https://doi.org/10.11648/j.js.20190705.13
    DO  - 10.11648/j.js.20190705.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 128
    EP  - 131
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20190705.13
    AB  - Context: Cannulated instruments are usually used while operating around the hip joint for fractures. For example, femoral neck fracture, intertrochanteric fracture, etc. Perioperative instrument breakage such as kirschner wires and guide pins is not infrequent. The fragment of instruments must be removed in order to avoid injury some important organizations. If the fragment further migrate to the acetabulum can result in serious or fatal complications. Removing a broken guide-wire is difficult and challenging even for experienced surgeons. Case Report: We present a simple and useful method to remove the broken guide-wire in the hip joint just using cannulated reamer to ream over the guide wire under the C-arm image intensifier. At first, confirm the cannulated reamer to sight the broken end of the wire, and passed through the broken guide-wire. Then, further reaming with low speed rotation till the beginning of the reamer encased the broken guide-wire. The reamer was withdrawn a few millimeters, after confirmation of the broken guide-wire dislodgment and firmly engaged within the drill lumen by the C-arm image intensifier. Reverse the guide-wire slightly with the reamer through the Proximal Femoral Nail hole. Conclusions: With this method, the authors were able to remove the broken guide wire easily in a few minutes.
    VL  - 7
    IS  - 5
    ER  - 

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