Broken guidewire protruding into the hip joint: A bone endoscopic-assisted retrieval method

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Implant Retrieval

Background:

• Broken guidewires during orthopedic surgery, particularly near joints, present significant retrieval challenges.
• Proximal femoral nail (PFN) procedures can be complicated by guidewire fractures, potentially leading to intra-articular fragments.

Purpose of the Study:

• To describe a minimally invasive endoscopic technique for extracting a broken guidewire fragment from the hip joint.
• To present a case of successful guidewire retrieval following PFN fixation of a femoral neck fracture.

Main Methods:

• Bone endoscopy using a 30° arthroscope was employed to visualize the intra-articular guidewire fragment.
• A specialized grasper was introduced under direct vision and confirmed with C-arm fluoroscopy for precise retrieval.
• The broken guidewire was grasped and removed, followed by replacement of the original screw.

Main Results:

• The 2-cm broken guidewire fragment, protruding into the hip joint, was successfully visualized and grasped.
• Complete retrieval of the guidewire fragment was achieved without further complications.
• The patient experienced fracture union and remained asymptomatic at 12-month follow-up.

Conclusions:

• Endoscopic retrieval is a viable and effective method for managing broken guidewires within the hip joint after PFN surgery.
• This technique minimizes invasiveness and facilitates successful management of intra-articular implant complications.