Document Detail

Fatal retroperitoneal hemorrhage caused by perforation of a guidewire pin for proximal femur fixation.
MedLine Citation:
PMID:  11995887     Owner:  NLM     Status:  MEDLINE    
A 77-year-old woman with a slightly displaced intertrochanteric two-fragment fracture of the left hip was treated by internal fixation using a screw-nail device (gamma nail). After the operation she became hemodynamically unstable, and ultrasound revealed a large retroperitoneal fluid accumulation in the left lower abdomen. A contrast computed tomogram revealed active hemorrhage next to the quadrilateral surface of the left acetabulum. Selective angiography and embolization were immediately initiated and stopped the bleeding. However, despite the successful treatment of the retroperitoneal hemorrhage, the patient developed an oligosymptomatic myocardial infarction associated with clinical evidence of a cerebrovascular insult and pulmonary decompensation and died 2 weeks after her accident. The hemorrhage in this patient was most likely caused by surgical damage to the obturator artery during placement of the guidewire pin (with threaded tip) to position the screw of the implant.
Michael Leunig; Michael Meyer; Martin Beck; Jürgen Triller; Alexander Stupnicki; Heinz Zimmermann
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  122     ISSN:  0936-8051     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-05-08     Completed Date:  2002-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  61-3     Citation Subset:  IM    
Department of Orthopedic Surgery, University of Berne, Inselspital, Switzerland.
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MeSH Terms
Bone Nails / adverse effects*
Fatal Outcome
Fracture Fixation, Internal / adverse effects*,  instrumentation*,  methods
Hemorrhage / diagnosis,  etiology*
Hip Fractures / diagnosis,  surgery
Peritoneal Cavity
Peritoneal Diseases / diagnosis,  etiology*
Postoperative Complications / diagnosis
Tomography, X-Ray Computed

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