Cement leakage into the hip joint during TFN-A cement augmentation in a revision surgery of an extra-capsular hip fracture

Abstract

Introduction: The intra-articular migration of the spiral lamina or screw, after close reduction and internal fixation (CRIF) with an intramedullary cervicodiaphyseal nail (cut-through), is one of the most frequent postoperative complications. We present a patient with a cut-through and cement leakage into the hip joint after TFN-A cement augmentation and spiral lamina replacement. Methods: A 83-year-old man, suffered a cut-through after CRIF of his left extracapsular hip fracture during the third postoperative month. A revision surgery was planned, including spiral lamina replacement and cement augmentation. Cement leakage into the hip joint was confirmed in the immediate postoperative radiograph and a new intervention was indicated with the removal of the third bodies. Results: The patient presented good clinical evolution, without functional limitation or pain. In routinely postoperative radiographic controls, no differences were observed respect to the immediate postoperative one. Discussion: Current literature dealing with implant revision surgery and associated cement augmentation are scarce. Conclusion: As far as we are concerned, this is the first case in the literature of a re-revision surgery of an extracapsular hip fracture due to a three months postoperative cut-through and a posterior cement leakage into the hip joint after TFN-A cement augmentation and spiral lamina replacement with the need of a posterolateral approach for removal. Keywords: Extracapsular hip fracture, Cut through, Cement augmentation, Nail revision surgery