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2026, Number 1

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Invest ISSSTE 2026; 1 (1)

Enterocutaneous fistula secondary to perforation from a migrated femoral intramedullary nail in a patient with chondrosarcoma: a case report

Isaias-Velázquez LA, Diaz-Suárez JA, Jasso-Rodríguez HS, Zermeño-Cuellar JM, Trinidad-Cruz DH, Sandoval-Gonzalez AM, Delgado-Sánchez JD
Full text How to cite this article

Language: Spanish
References: 6
Page: 30-33
PDF size: 656.65 Kb.


Key words:

intramedullary nail, intestinal perforation, enterocutaneous fistula.

ABSTRACT

We present the case of a 71-year-old female patient with a left femoral intramedullary nail, who sustained a new femoral fracture and had a prior history of chondrosarcoma. She developed fecaloid discharge from the thigh, and imaging revealed sigmoid colon perforation secondary to intramedullary nail migration. The patient underwent laparotomy with nail removal and loop ostomy formation, and was discharged in improved condition after a 4-week course of intravenous antibiotic therapy. The management of pathologic fractures should focus on prevention and early detection of complications arising from pre-existing bone damage.


REFERENCES

  1. San Julián-Arangurena M. El clavo intramedular en patologíatumoral de los huesos largos. Rev Esp Cir Ortop Traumatol. 2001;45(4):284-289.

  2. Jeys LM, Thorkildsen J, Kurisunkal V, Puri A, Ruggieri P, HoudekMT, et al. Controversies in orthopaedic oncology: attemptinginternational consensus. Bone Joint J. 2024;106-B(5):425-429.doi: 10.1302/0301-620X.106B5.BJJ-2023-1381

  3. Anastasopoulos PP, Lepetsos P, Leonidou AO, Gketsos A,Tsiridis E, Macheras GA. Intra-abdominal and intra-pelviccomplications following operations around the hip: causesand management—a review of the literature. Eur J OrthopSurg Traumatol. 2018;28(6):1017-1027. doi: 10.1007/s00590-018-2154-6.

  4. Tauber M, Resch H. Sigmoid perforation after medial migrationof lag screw in gamma nailing. Arch Orthop Trauma Surg.2006;126(2):118-122. doi: 10.1007/s00402-005-0085-2.

  5. Kyriakidis AV, Papanikolaou S, Perysinakis I, VezyrgiannisI, Xantzis L, Papadopoylos C, et al. Intraabdominal injuriescaused by migration of guide wire after intramedullaryosteosynthesis in intertrochanteric hip fracture. HellCheirourgike. 2010;82(6):397-400. doi: 10.1007/s13126-010-0062-2.

  6. Kantiwal P, Yadav S, Nalwa A, Elhence A. Pathologicalfracture treated with total femoral replacement in a caseof chondrosarcoma involving the entire-length femoralshaft. Int J Surg Case Rep. 2024;116:109413. doi: 10.1016/j.ijscr.2024.109413.




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Invest ISSSTE. 2026;1