Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter
Aside from cases of mechanical complications or infection short femoral nails (SFNs) are not removed after open reduction and internal fixation (ORIF) because femoral trochanteric fractures often occur in older osteoporotic females. Occasionally, SFN removal is performed because of severe chronic hi...
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doaj-27eb277719b04e86af36a85e3e98470f2021-10-07T04:26:21ZengElsevierTrauma Case Reports2352-64402021-12-0136100542Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanterHirokazu Takai0Masato Kitajima1Seiko Takai2Tomoki Takahashi3Corresponding author at: Department of Orthopaedic Surgery, Kumamoto Kinoh Hospital, 6-8-1 Yamamuro, Kitaku, Kumamoto 860-8518, Japan.; Department of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, JapanDepartment of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, JapanDepartment of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, JapanDepartment of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, JapanAside from cases of mechanical complications or infection short femoral nails (SFNs) are not removed after open reduction and internal fixation (ORIF) because femoral trochanteric fractures often occur in older osteoporotic females. Occasionally, SFN removal is performed because of severe chronic hip and thigh pain after surgery. However, cases of large hematoma formation in the gluteus medius with associated severe pain have not been reported in patients after ORIF.A 58-year-old healthy woman fell and incurred a femoral trochanteric fracture at work. ORIF was performed using Gamma nail for the fracture, which was classified as AO31-1.2 according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification. The bone healed sufficiently. The patient reported chronic hip and thigh pain after ORIF, but the SFN was not removed because of concerns about further fractures. After 1 year and 8 months, she suddenly experienced severe hip and thigh pain with hip swelling, but without prior trauma. Magnetic resonance imaging (MRI) showed a large hematoma in the gluteus medius near the greater trochanter. Under general anesthesia, SFN removal was performed because of the persistent pain. After SFN removal, the chronic pain resolved without any complications, such as a femoral neck fracture.In this case, chronic hip and thigh pain and delayed hematoma may have been caused by SFN protrusion over the greater trochanter, damaging soft tissues around the gluteus medius. Thus, soft tissue injury and hematoma are possible in patients with chronic hip and thigh pain after ORIF using SFN. In using SFN for femoral trochanteric fractures, it is important to prevent protrusion of SFN over the greater trochanter. Further careful follow-up with MRI and/or ultrasonography is needed to study delayed hematoma after ORIF using SFN.http://www.sciencedirect.com/science/article/pii/S2352644021001473Femoral trochanteric fractureShort femoral nail (SFN)Gamma nail protrusionDelayed hematomaHip and thigh pain |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hirokazu Takai Masato Kitajima Seiko Takai Tomoki Takahashi |
spellingShingle |
Hirokazu Takai Masato Kitajima Seiko Takai Tomoki Takahashi Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter Trauma Case Reports Femoral trochanteric fracture Short femoral nail (SFN) Gamma nail protrusion Delayed hematoma Hip and thigh pain |
author_facet |
Hirokazu Takai Masato Kitajima Seiko Takai Tomoki Takahashi |
author_sort |
Hirokazu Takai |
title |
Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter |
title_short |
Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter |
title_full |
Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter |
title_fullStr |
Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter |
title_full_unstemmed |
Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter |
title_sort |
delayed hematoma in gluteus medius caused by gamma nail protrusion over the greater trochanter |
publisher |
Elsevier |
series |
Trauma Case Reports |
issn |
2352-6440 |
publishDate |
2021-12-01 |
description |
Aside from cases of mechanical complications or infection short femoral nails (SFNs) are not removed after open reduction and internal fixation (ORIF) because femoral trochanteric fractures often occur in older osteoporotic females. Occasionally, SFN removal is performed because of severe chronic hip and thigh pain after surgery. However, cases of large hematoma formation in the gluteus medius with associated severe pain have not been reported in patients after ORIF.A 58-year-old healthy woman fell and incurred a femoral trochanteric fracture at work. ORIF was performed using Gamma nail for the fracture, which was classified as AO31-1.2 according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification. The bone healed sufficiently. The patient reported chronic hip and thigh pain after ORIF, but the SFN was not removed because of concerns about further fractures. After 1 year and 8 months, she suddenly experienced severe hip and thigh pain with hip swelling, but without prior trauma. Magnetic resonance imaging (MRI) showed a large hematoma in the gluteus medius near the greater trochanter. Under general anesthesia, SFN removal was performed because of the persistent pain. After SFN removal, the chronic pain resolved without any complications, such as a femoral neck fracture.In this case, chronic hip and thigh pain and delayed hematoma may have been caused by SFN protrusion over the greater trochanter, damaging soft tissues around the gluteus medius. Thus, soft tissue injury and hematoma are possible in patients with chronic hip and thigh pain after ORIF using SFN. In using SFN for femoral trochanteric fractures, it is important to prevent protrusion of SFN over the greater trochanter. Further careful follow-up with MRI and/or ultrasonography is needed to study delayed hematoma after ORIF using SFN. |
topic |
Femoral trochanteric fracture Short femoral nail (SFN) Gamma nail protrusion Delayed hematoma Hip and thigh pain |
url |
http://www.sciencedirect.com/science/article/pii/S2352644021001473 |
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