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Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction

Background and Objectives: Steinmann pins are commonly used in orthopedics, with a low rate of complications. However, thermal osteonecrosis may occur when a pin is inserted using a drill. There have been no reports on late-onset fractures at the Steinmann pin insertion site. Materials and Methods:...

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Autores principales: Hong, Chang-Hwa, Park, Jong-Seok, Jang, Byung-Woong, Jang, Heejun, Kim, Chang-Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949153/
https://www.ncbi.nlm.nih.gov/pubmed/35334582
http://dx.doi.org/10.3390/medicina58030404
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author Hong, Chang-Hwa
Park, Jong-Seok
Jang, Byung-Woong
Jang, Heejun
Kim, Chang-Hyun
author_facet Hong, Chang-Hwa
Park, Jong-Seok
Jang, Byung-Woong
Jang, Heejun
Kim, Chang-Hyun
author_sort Hong, Chang-Hwa
collection PubMed
description Background and Objectives: Steinmann pins are commonly used in orthopedics, with a low rate of complications. However, thermal osteonecrosis may occur when a pin is inserted using a drill. There have been no reports on late-onset fractures at the Steinmann pin insertion site. Materials and Methods: A 32-year-old man who underwent surgery for a femoral shaft fracture 5 years ago complained of proximal thigh pain 1 month after the removal of the internal device. On physical examination, the patient showed a limping gait due to pain, and tenderness was observed on the lateral aspect of the proximal thigh. Magnetic resonance imaging was performed because the symptoms did not improve, despite conservative treatment. A new fracture line was observed in the lateral cortical bone of the proximal femur. It was found that a fracture occurred at the site where the Steinmann pin was inserted for a closed reduction at the time of the first operation. The patient was instructed to limit weight bearing and to use crutches while walking. Parathyroid hormone was additionally administered to promote bone formation. Results: Six months after diagnosis, a complete union was achieved at the subtrochanteric fracture site, and the patient’s pain subsided. Conclusions: A fracture that occurs as a late onset at the provisional Steinmann pin insertion site is an extremely rare complication; however, orthopedic surgeons must consider this possibility and make more efforts to lower the occurrence of thermal damage. In addition, if the patient complains of pain in the region where the pin was inserted after surgery, surgeons should spare no effort to determine whether a new fracture has occurred.
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spelling pubmed-89491532022-03-26 Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction Hong, Chang-Hwa Park, Jong-Seok Jang, Byung-Woong Jang, Heejun Kim, Chang-Hyun Medicina (Kaunas) Case Report Background and Objectives: Steinmann pins are commonly used in orthopedics, with a low rate of complications. However, thermal osteonecrosis may occur when a pin is inserted using a drill. There have been no reports on late-onset fractures at the Steinmann pin insertion site. Materials and Methods: A 32-year-old man who underwent surgery for a femoral shaft fracture 5 years ago complained of proximal thigh pain 1 month after the removal of the internal device. On physical examination, the patient showed a limping gait due to pain, and tenderness was observed on the lateral aspect of the proximal thigh. Magnetic resonance imaging was performed because the symptoms did not improve, despite conservative treatment. A new fracture line was observed in the lateral cortical bone of the proximal femur. It was found that a fracture occurred at the site where the Steinmann pin was inserted for a closed reduction at the time of the first operation. The patient was instructed to limit weight bearing and to use crutches while walking. Parathyroid hormone was additionally administered to promote bone formation. Results: Six months after diagnosis, a complete union was achieved at the subtrochanteric fracture site, and the patient’s pain subsided. Conclusions: A fracture that occurs as a late onset at the provisional Steinmann pin insertion site is an extremely rare complication; however, orthopedic surgeons must consider this possibility and make more efforts to lower the occurrence of thermal damage. In addition, if the patient complains of pain in the region where the pin was inserted after surgery, surgeons should spare no effort to determine whether a new fracture has occurred. MDPI 2022-03-09 /pmc/articles/PMC8949153/ /pubmed/35334582 http://dx.doi.org/10.3390/medicina58030404 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Hong, Chang-Hwa
Park, Jong-Seok
Jang, Byung-Woong
Jang, Heejun
Kim, Chang-Hyun
Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title_full Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title_fullStr Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title_full_unstemmed Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title_short Subtrochanteric Insufficiency Fracture Occurring 5 Years after Surgery at the Steinmann Pin Insertion Site for Fracture Reduction
title_sort subtrochanteric insufficiency fracture occurring 5 years after surgery at the steinmann pin insertion site for fracture reduction
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949153/
https://www.ncbi.nlm.nih.gov/pubmed/35334582
http://dx.doi.org/10.3390/medicina58030404
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