Fatal injury to the external iliac vein by a guide wire during use of a dynamic hip screw (DHS)

There are only a few reports about injury to vital anatomical structures by Kirschner wires in literature. In the case described here the guide wire o f the dynamic hip screw caused a fatal injury to the external iliac vein wh ich was not at first evident. The guide wire had obviously become caught up in the combination three-diameter drill and screwed by the drill into the pelvis. After a stable interval the patient suffered circulatory collapse. Emergency treatment and resuscitation attempts followed with no possibility of surgical intervention. The nature of the injury was established and des cribed in a postmortem examination (photos). The distances were measured on the actual bone. The conclusion of the two experts assessing this case was that this rare injury was not due to malpractice.