J Korean Fract Soc.  2015 Oct;28(4):250-255. 10.12671/jkfs.2015.28.4.250.

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

• Chung KJ
• Jeon JY
• Na HW
• Hwang JH

• KMID: 2070352
• DOI: http://doi.org/10.12671/jkfs.2015.28.4.250

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.

Keyword

Iatrogenic disease; Stress riser; Subtrochanter; Femur

MeSH Terms

Elastic Modulus
Femur
Hip Fractures*
Human Body
Iatrogenic Disease
Malpractice
Medical Errors*
Prevalence
Tibia
Weight-Bearing

Figure

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  Fig. 1 X-ray shows a femoral neck fracture in a 63-year-old male.

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  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.

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  Fig. 3 The new fracture occurred at the level of empty holes and screw heads area.

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  Fig. 4 The fracture was reducted by a proximal femur nail (PFN®).

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  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.

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  Fig. 6 Hot uptake in the old fracture area and the screw heads area.

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  Fig. 7 The new fracture occurred at the distal tip of the screws.

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  Fig. 8 The subtrochanter fracture was reducted by PFNA® after removal of the screws.

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