title: Intrapelvic migration of the lag screw in intramedullary nailing.
abstract: Internal fixation with intramedullary devices has gained popularity for the treatment of intertrochanteric femoral fractures, which are common injuries in the elderly. The most common complications are lag screw cut out from the femoral head and femoral fracture at the distal tip of the nail. We report here a rare complication of postoperative lag screw migration into the pelvis with no trauma. The patient was subsequently treated with lag screw removal and revision surgery with total hip arthroplasty. This case demonstrated that optimal fracture reduction and positioning of the lag screw are the most important surgical steps for decreasing the risk of medial migration of the lag screw. Furthermore, to prevent complications, careful attention should be paid to subsequent steps such as precise insertion of the set screw.
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Tomoya
authors.identifier: 0000-0002-4644-2782
authors.initials: T
authors.lastname: Takasago
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Tomohiro
authors.identifier: 0000-0002-7918-7837
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Toki
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hamada
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshioka
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Ichiro
authors.identifier: 0000-0003-1394-8784
authors.initials: I
authors.lastname: Tonogai
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tsutsui
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Tamaki
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Keizo
authors.identifier: 0000-0002-8779-1348
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo