Abstract
Relevance. Trochanteric femoral fractures are common in elderly patients and are mainly treated using intramedullary fixation devices. Despite this method's effectiveness, rare but potentially life-threatening complications may occur. Case report. We present a clinical case of an extremely rare complication, medial migration of a Gamma nail lag screw into the pelvic cavity with perforation of the urinary bladder. The patient presented with lower abdominal pain and urinary symptoms several months after osteosynthesis. Radiological and tomographic examinations revealed migration of the screw into the urinary bladder. Surgical removal of the implant with subsequent bladder repair was performed. Conclusion. This clinical case demonstrates the potential for severe complications even after technically satisfactory primary osteosynthesis and highlights the importance of careful postoperative monitoring and a multidisciplinary approach to treatment.