Intra-Pelvic Migration of Sliding Hip Screw During Osteosynthesis of Hip Fracture: A Rare Avoidable Intraoperative Complication

INTRODUCTION: Hip fractures, which are common among old patients, are classified into two groups: intracapsular and extracapsular fractures. Extracapsular fractures can be treated with extramedullary implants [e.g. dynamic hip screw (DHS)] or intramedullary nails. Dynamic hip screw is the treatment of choice in stable pertrochanteric fractures. Intrapelvic migration of the sliding screw is a very rare complication. CASE REPORT: We report a case of a 90-year old Caucasian woman who had an unusual intraoperative complication during osteosynthesis procedure for extracapsular hip fracture fixation. In fact, the sliding hip screw went deep into the pelvis during surgery. This mishap required an abdominal surgical approach by the general surgeon to remove the screw. CONCLUSION: Taking into consideration the poor quality of the bone in very old patients, we emphasize the importance of following every single step of the surgical procedure, in order to minimize the risk of this complication.