Intraoperative External Iliac Venogram and Intravenous Ultrasound to Assist Retrieval of Intrapelvic Acetabular Screw

Intrapelvic acetabular screw placement is a known complication of total hip arthroplasty and is associated with risks including damage to neurovascular and intrapelvic structures such as the external iliac vessels, obturator vessels, and iliopsoas muscles. Retrieval of intrapelvic acetabular screws is similarly fraught with risk, and appropriate imaging should be performed preoperatively. We report on a case of intrapelvic acetabular screw placement with abutment of the external iliac vein, which was managed with intraoperative venogram and intravenous ultrasound to maintain access to the external iliac vein and successfully show no vascular tear before and after screw removal.