Removing a broken guidewire in the hip joint: treatment options and recommendations for preventing an avoidable surgical catastrophe. A case report

ABSTRACT CONTEXT: Hardware breakage during hip surgery can pose challenging and difficult problems for orthopedic surgeons. Apart from technical difficulties relating to retrieval of the broken hardware, complications such as adjacent joint arthritis and damage to neurovascular structures and major viscera can occur. Complications occurring during the perioperative period must be informed to the patient and proper documentation is essential. The treatment options must be discussed with the patient and relatives and the implant company must be informed about this untoward incident. CASE REPORT: We report a case of complete removal of the implant and then removal of the broken guidewire using a combination of techniques, including a cannulated drill bit, pituitary forceps and Kerrison rongeur. CONCLUSIONS: We suggest some treatment options and recommendations for preventing an avoidable surgical catastrophe.研究背景：髋关节手术中内置物断裂会给骨科医师带来极具挑战性的诊疗难题。除了取出断裂内置物所面临的技术难点外，还可能引发邻近关节关节炎、神经血管结构损伤及重要脏器受损等并发症。围手术期出现的并发症需及时告知患者，且完善的病例记录至关重要。临床医师需与患者及其家属充分商讨治疗方案，并将该不良事件告知内置物生产企业。 病例报告：我们报告1例采用包括空心钻头、垂体钳及Kerrison咬骨钳（Kerrison rongeur）在内的联合手术技术，完整取出内置物后成功取出断裂导丝的病例。 结论：我们提出了若干治疗方案及预防此类可避免的手术灾难的相关建议。