Intraosseous Retrieval of Broken Guide Wire while Fixing Proximal Femur Fractures – A Report of 2 Cases and Review of Literature

• Published in: Journal of orthopaedic case reports 2023, Vol.13 (11), p.37-41
• Main Authors: Samant, Vinay, Shaikh, Ashraf, Desai, Mohan, Prabhu, Rudra, Sekhrajka, Rachit, Somani, Rohit
• Format: Article
• Language: English
• ISSN: 2321-3817; 2321-3817
• DOI: 10.13107/jocr.2023.v13.i11.3998

Introduction: Hardware breakage during surgery is a known risk that may result in serious complications. Drill bits and guide wires are particularly prone to breakage, and if not promptly recognized and removed, can cause damage to intrapelvic structures, or may lead to hip arthritis later. Herein, we present two cases in which broken guide wire fragments were safely retrieved through the same incision, resulting in good outcomes and reduced morbidity. Case Report: In the first case, a broken guide wire piece that had been pushed into the hip joint during intertrochanteric fracture surgery was retrieved using disc forceps after reaming over the same guide tract. In the second case, the broken tip of a partially withdrawn guide wire was removed from a transcervical femur fracture using a cannulated drill bit. Conclusion: Our approach highlights the importance of attempting retrieval of broken hardware through the same tract using unconventional instruments, such as disc forceps, before resorting to more invasive methods, such as arthrotomy or separate incisions. These cases demonstrate the feasibility of this approach and its potential to reduce morbidity associated with hardware retrieval. Keywords: Proximal femur fracture, broken hardware, unconventional methods, drill bits, guide wires, disc forceps.