Management of Retained Epidural Catheter Fragment in a Polytrauma Patient: A Case Report.
- 1Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, India.
- 2Department of Anaesthesia, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Abstract
Epidural catheterization is a commonly performed procedure for perioperative analgesia in orthopedic surgery. Catheter fracture is an uncommon but potentially challenging complication that may present a management dilemma when a retained fragment is identified. Although retained fragments have traditionally been considered biologically inert, delayed complications, such as radicular pain, migration, and fibrosis have been reported. However, consensus regarding optimal management remains lacking. We report a case of an epidural catheter fracture during insertion, with a retained fragment confirmed by comparison with the original catheter. Localization was done using computed tomography at the L3-L4 level, extending from the interspinous region towards the posterior epidural space. The patient remained neurologically intact throughout the course of treatment. During a subsequent planned orthopedic procedure, retrieval of the retained catheter fragment was performed through a limited posterior approach. The fragment was successfully removed under direct visualization without dural breach or cerebrospinal fluid leak. The post-operative course was uneventful, and the patient remained asymptomatic at follow-up. Management of retained epidural catheter fragments remains debated. While conservative observation has been reported in asymptomatic patients, delayed complications, including migration, fibrosis, and neurological symptoms have also been described. Careful radiological localization and correlation with clinical features are important when formulating a management strategy. This case highlights the role of individualized decision-making and multidisciplinary planning in the management of retained epidural catheter fragments.
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BibTeX
@article{singla2026management,
title = {{Management of Retained Epidural Catheter Fragment in a Polytrauma Patient: A Case Report.}},
author = {Ayush Singla and Ankit Rai and Nilesh Barwar and Pankaj Kumar Sharma and Uma Rathi and Himanshu Chahal},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8384},
url = {https://europepmc.org/article/MED/42997226},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Management of Retained Epidural Catheter Fragment in a Polytrauma Patient: A Case Report.
AU - Ayush Singla
AU - Ankit Rai
AU - Nilesh Barwar
AU - Pankaj Kumar Sharma
AU - Uma Rathi
AU - Himanshu Chahal
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8384
UR - https://europepmc.org/article/MED/42997226
AB - Epidural catheterization is a commonly performed procedure for perioperative analgesia in orthopedic surgery. Catheter fracture is an uncommon but potentially challenging complication that may present a management dilemma when a retained fragment is identified. Although retained fragments have traditionally been considered biologically inert, delayed complications, such as radicular pain, migration, and fibrosis have been reported. However, consensus regarding optimal management remains lacking. We report a case of an epidural catheter fracture during insertion, with a retained fragment confirmed by comparison with the original catheter. Localization was done using computed tomography at the L3-L4 level, extending from the interspinous region towards the posterior epidural space. The patient remained neurologically intact throughout the course of treatment. During a subsequent planned orthopedic procedure, retrieval of the retained catheter fragment was performed through a limited posterior approach. The fragment was successfully removed under direct visualization without dural breach or cerebrospinal fluid leak. The post-operative course was uneventful, and the patient remained asymptomatic at follow-up. Management of retained epidural catheter fragments remains debated. While conservative observation has been reported in asymptomatic patients, delayed complications, including migration, fibrosis, and neurological symptoms have also been described. Careful radiological localization and correlation with clinical features are important when formulating a management strategy. This case highlights the role of individualized decision-making and multidisciplinary planning in the management of retained epidural catheter fragments.
SN - 2250-0685
SN - 2321-3817
ER -