title: Broken guidewire protruding into the hip joint: A bone endoscopic-assisted retrieval method.
abstract: Broken implants, especially broken wires at difficult sites, may pose a challenge for the treating orthopedic surgeon. We describe a method for extraction of a broken guidewire that was, protruding into the hip joint following the insertion of a proximal femoral nail. A 35-year-old man with displaced femoral neck fracture with ipsilateral fracture shaft of femur was operated and fixed with long proximal femoral nail. The guidewire of proximal screw broke during the process of drilling. The tip of the 2-cm-long broken guidewire was touching the articular surface. The guidewire was misdirected posteroinferiorly from its path for the insertion of the proximal screw (6.8 mm), this screw was removed and bone endoscopy was performed with a 30° arthroscope. The broken end of the guidewire was located under direct vision. The grasper was introduced with its jaws at the 8 O'clock position and its position was confirmed under a C-arm image intensifier in both anteroposterior and lateral views. The broken end of the guidewire was grasped and it was retrieved. The screw was replaced in its original track to complete the procedure. The fractures united and patient was asymptomatic when last followed-up at 12 months.
authors.affiliation: Department of Orthopedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Arora
authors.forename: Lalit
authors.initials: L
authors.lastname: Maini
authors.forename: Vinay
authors.initials: V
authors.lastname: Aggarwal
authors.forename: Anil
authors.initials: A
authors.lastname: Dhal