MÜSLİM YURTÇU, Hakan ŞENARAN, Hakan H. TÜRK, Adnan ABASIYANIK, İbrahim TUNCAY

Gelişimsel kalça displazisi cerrahisi sonrası intra-artiküler K telinin karşı pelvise migrasyonu: Olgu sunumu

Sorunlu gelişimsel kalça displazisi (GKD) vakalarında, femur başının transartiküler olarak K teli ile asetabuluma tespit edilmesi seyrek olarak uygulanan bir cerrahi yöntemdir. Bu yazıda, GKD tedavisi sonrası semptom olmaksızın K telinin pelvis içine transveziküler migrasyonu tespit edilen çocuk hasta sunulmaktadır. Çift taraşı GKD nedeniyle 4 yıl önce çok sayıda operasyon geçiren 8 yaşındaki kız hasta, aksayarak yürüme şikayeti ile ortopedi polikliniğine başvurdu. Her iki kalçanın hareket açıklığı iyi idi. Pelvis radyografisinde, her iki kalça arasında köprü gibi uzanan intrapelvik K teli tespit edildi. Hastanın önceki ameliyatlar sonrası ürogenital ve intestinal sistemlerle ilgili şikayetinin olmadığı belirlendi. Pediatrik cerrahi işbirliği ile K telinin çıkarılması planlandı. Sistoskopide K telinin mesane içinden geçtiği görüldü. Laparotomide K teli ortadan kesildi ve vücuttan çıkarıldı. Hasta taburcu edildi ve postoperatif şikayeti olmadı. K telinin vücutta bırakılması durumunda migrasyon riski yüksektir. Muhtemel komplikasyonların önlenmesi için K telinin postoperatif dönemde erken çıkarılması planlanmalıdır.

Migration of intra-articular K-wire into the contralateral pelvis after surgery for developmental dysplasia of the hip: A case report

Transarticular fixation of femoral head into acetabulum with K-wire is a seldomly used surgical method in difficult cases of developmental dysplasia of the hip (DDH). This paper presents a child with intrapelvic transvesicular migration of a K-wire without any symptoms after treatment of DDH. Eight years old girl who had multiple surgeries 4 years ago due to bilateral DDH applied to the orthopedics clinic with limping. She had good range of motion of both hips. At the pelvis radiograph, there was an intrapelvic K-wire standing between two hemipelvises like a bridge. She did not have any enteral and urological symptoms after the previous operations. We planned to remove the K-wire in cooperation with the pediatric surgery department. On the cystoscopy, K-wire was seen passing through the urinary bladder. Wire was cut at the middle point and taken out of the body by laparotomy. The patient was discharged without any postoperative complications. K-wire retention in the body has high chance of migration. Early postoperative removal of the K-wire is necessary to prevent possible complications.

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