Medical Journal of the Islamic Republic Of Iran

en Migration of the Gamma Nail Neck Screw into the Pelvis with Bladder Damage COVID 19 case report case report     Background: Medial migration of the cervical screw is a frequent complication of Gamma nails and is observed in 4.3% - 6% of cases. The reasons are a violation of the surgical technique of osteosynthesis of a trochanter fracture, including an unrepaired fracture, a breach of the insertion point of the fixator, and a suboptimal position of the cervical screw. However, the migration of the Gamma nail neck screw into the pelvic cavity is sporadic, and only a few cases have been published in the literature.    Case description: This is the case of a patient born in 1952 who was admitted to the hospital with pain syndrome in the pelvis and dysuric phenomena. As a result of clinical X-ray examination, CT, and MRT examination of the pelvis, medial migration of the Gamma nail cervical screw with damage to the bladder was revealed. The patient was urgently operated on the day of admission. The cervical screw from the bladder was removed, the bladder was sutured, and an epicystostomy was installed. The Gamma nail from the right femur was also released. There were no intraoperative complications. In the postoperative period, the patient was prescribed antibiotics and analgesics. The duration of hospitalization was six days. Being examined for five weeks after the operation, the patient does not make any particular complaints, walks without means of support, and the intertrochanteric fracture of the right femur fused incorrectly. The patient was offered an endoprosthesis of the right hip joint, but he and his relatives refused.    Conclusion: The traumatologist should be aware of the possibility of such complications after osteosynthesis and its associated risks. They should be able to recognize the etiological factors causing the medial migration of the cervical screw of the intramedullary retainer. If medial screw migration is detected, the traumatologist should assess the function of internal organs and the condition of the main vessels and take measures to safely remove the migrated fixator from the anatomical cavity of the body in one team with a surgeon, urologist and  vascular surgeon.   Trochanter Fracture, Osteosynthesis, Gamma Nail, Cervical Screw, Migration, Bladder, Perforation 383 388 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8476-1&slc_lang=en&sid=1 Ergali Nabiyev 9193md@mail.ru 200319475328460089295 200319475328460089295 No KazNMU named S.D. Asfendiyarov, Kazakhstan Ramazan Askerov Askerov.ramazan@mail.ru 200319475328460089296 200319475328460089296 No Kazakhstan’s Medikal University “KSPH”, Kazakhstan Khadisha Kashikova hadishakash@gmail.com 200319475328460089297 200319475328460089297 Yes Kazakhstan’s Medikal University “KSPH”, Kazakhstan Arnat Baizakov Arnat_bayzakov@mail.ru 200319475328460089298 200319475328460089298 No Kazakhstan’s Medikal University “KSPH”, Kazakhstan Zhassulan Argynbayev Argynbayev.zhasulan@gmail.com 200319475328460089299 200319475328460089299 No Kazakhstan’s Medikal University “KSPH”, Kazakhstan Zhenisbek Baubekov zh.tanir@mail.ru 200319475328460089300 200319475328460089300 No West Kazakhstan Marat Ospanov Medical University Kuanysh Baikubesov ortoped48@mail.ru 200319475328460089301 200319475328460089301 No Caspian University, International School of Medicine, Almaty, Kazakhstan