RISK OF PELVIC INJURY FROM FEMORAL-NECK GUIDEWIRES

Many of the devices used in the internal fixation of femoral neck frac tures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally adva nced inadvertently through the hip joint and the acetabulum. Pelvic vi sceral damage may follow. To assess this risk, we inserted three guide wires to a depth of 16 cm into each femoral neck of ten cadavers and e xplored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries ass ociated with hip surgery is reviewed, and suggestions are offered on t he avoidance of pelvic penetration during hip fracture fixation.