Iatrogenic Tibia Fracture from an "Errant" Traction Pin Placement Resulting in a Cortical Defect: A Case Study

A 78-year-old women presented with a closed left midshaft femur fracture after sustaining a fall from standing height and underwent proximal tibial traction pin placement. After subsequent intramedullary nailing of femur fracture, the patient returned 2 months later with a proximal tibia fracture through the unicortical defect left from the traction pin site and underwent successful intramedullary nailing of the tibia.

Errant anteriorly placed proximal tibial traction pins pass tangentially across the vertex of the tibia and create residual unicortical defects that may increase the risk for late iatrogenic pin site fractures.