title: Breakage of intramedullary femoral guide rod during total knee arthroplasty: a case report.
abstract: We report a rare complication during primary total knee arthroplasty. An intramedullary femoral guide rod was broken during insertion. The broken part jammed into the isthmus of the femur. An initial attempt to push the broken rod via the proximal femur by a guide wire to the distal femur was unsuccessful because the broken rod was lodged in the isthmus. Ultimately, the isthmus was opened using a flexible 9-mm end-cutting reamer, and the broken rod was pushed down to the distal femoral entry site in an antegrade fashion under image intensification. Selecting a more medial entry site on the intercondylar notch with a smaller valgus cutting angle and using a shorter guide rod can avoid such a breakage.
authors.affiliation: Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong.
authors.forename: W L
authors.initials: WL
authors.lastname: Chan
authors.forename: C H
authors.initials: CH
authors.lastname: Yen
authors.forename: K K
authors.initials: KK
authors.lastname: Wong
authors.forename: P Y T
authors.initials: PY
authors.lastname: Tse
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008875:Middle Aged