Iatrogenic Subtrochanteric Fractures Related to the Surgical Error: Two Cases Report

Kook Jin Chung; June Young Jeon; Hyun Woo Na; Ji Hyo Hwang

doi:10.12671/jkfs.2015.28.4.250

Journal List > J Korean Fract Soc > v.28(4) > 1038040

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Chung, Jeon, Na, and Hwang: Iatrogenic Subtrochanteric Fractures Related to the Surgical Error: Two Cases Report

Case Report

Journal of the Korean Fracture Society 2015; 28(4): 250-255.

Published online: 19 October 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.4.250

Iatrogenic Subtrochanteric Fractures Related to the Surgical Error: Two Cases Report

Kook Jin Chung, M.D., June Young Jeon, M.D., Hyun Woo Na, M.D., Ji Hyo Hwang, M.D., Ph.D.

Department of Orthopaedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.

Address reprint requests to: Address reprint requests to: Ji Hyo Hwang, M.D., Ph.D. Department of Orthopaedic Surgery, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea. Tel: 82-2-829-5435, Fax: 82-2-848-6020, hwangjihyo7309@gmail.com

Received 2 September 2015 Revised 5 September 2015 Accepted 5 September 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Iatrogenic fracture is not popular and might be recognized as a malpractice. Surgical error related to iatrogenic fracture which has occurred after an operation can be detected only by a surgeon. Stress riser fracture is another form of iatrogenic fracture also known as a Young's modulus fracture. As the majority of surgical related stress riser fractures can be preventive, the accurate prevalence is not known. The majority of fractures occurred in the weight bearing bones such as femur and tibia. The subtrochanter area is the most stress concentrated area in the human body, thus it is a common area for occurrence of stress riser iatrogenic fractures. We experienced 2 cases of stress riser iatrogenic fractures, which are related to technical errors, thus we report cases with literature review.

Keywords: Iatrogenic disease, Stress riser, Subtrochanter, Femur

Figures and Tables

Fig. 1

X-ray shows a femoral neck fracture in a 63-year-old male.

Fig. 2

Three cannulated screws were too clustered and empty screw holes remained in the lateral cortex which is not seen in the plain X-ray.

Fig. 3

The new fracture occurred at the level of empty holes and screw heads area.

Fig. 4

The fracture was reducted by a proximal femur nail (PFN®).

Fig. 5

An 81-year-old female was transferred due to hip pain. She was treated by in situ pin fixation at the local clinic. The two screws were located below the level of the lesser trochanter.

Fig. 6

Hot uptake in the old fracture area and the screw heads area.

Fig. 7

The new fracture occurred at the distal tip of the screws.

Fig. 8

The subtrochanter fracture was reducted by PFNA® after removal of the screws.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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