大腿骨転子部骨折に対するＣＨＳ抜釘術後に同側大腿骨頚部骨折を来した一症例

Abstract

Femoral neck fracture after a healed trochanteric fracture is rare. We experienced one case of femoral neck fracture after removal of the compression hip screw. A 90-year-old woman sustained a two part stable trochanteric hip fracture that was reduced and stabilized with a compression hip screw. Postoperative radiographs showed that the lag screw was positioned very properly. The fracture healed. Six months later, radiographs showed lag screw penetration. The patient reported occasional gait hip pain. We decided to remove the implants, to prevent the acetabular cartilages from destruction. The device was removed, and the patient was discharged two weeks later. She returned 21 days after removal because of increasing groin pain without evidence of trauma. Radiographs did not showed the fracture line. But magnetic resonance intensifier images revealed a subcapital femoral neck fracture. A bipolar end prosthesis was performed the following day. The combination of bone defects present after implant removal and osteoporosis may contribute to the weakness of the subcapital region of the femoral neck. We hope to draw attention to the possibility of femoral neck fracture as a serious and frequent complication after implant removal.