Medial migration of lag screw after gamma nailing

Injury. 2014 Aug;45(8):1275-9. doi: 10.1016/j.injury.2014.04.016. Epub 2014 May 10.


Fractures of the proximal femur are common in the elderly population. Intramedullary nailing has become the standard treatment for intertrochanteric fractures although several extramedullary implants (e.g. dynamic hip screw (DHS), blade plate, locking compression plate (LCP), etc.) exist. However, despite this being a very common operation in traumatology, there are numerous associated complications. We report the rare complication of the migration of the medial lag screw into the pelvis at five and a half weeks postoperatively. The implant was removed and replaced by a total hip arthroplasty with simultaneous grafting of the acetabular defect and strapping of the greater trochanter. The evolution was favourable. We also present a review of the literature and analyze our case.

Keywords: Intertrochanteric fractures; Intramedullary nailing; Lag screw medial migration.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / methods
  • Bone Screws*
  • Device Removal*
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / surgery*
  • Fracture Fixation, Intramedullary / adverse effects
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / surgery*
  • Humans
  • Pelvis / diagnostic imaging*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery*
  • Radiography
  • Treatment Outcome