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Intermediate Technical IVT

Cortical breach

Perforation or disruption of the cortical bone wall, often occurring during surgical procedures.

Full Definition

A cortical breach refers to an unintended perforation or breaking through of the cortical bone surface, commonly occurring during drilling, screw insertion, or reaming procedures in orthopedic surgery. This complication can compromise fixation strength, create stress concentrations, or provide pathways for infection. Cortical breaches may occur in the far cortex during screw insertion or along the shaft during intramedullary nailing. Recognition and appropriate management of cortical breaches are important for maintaining construct stability and preventing complications such as thermal necrosis or hardware migration.

Usage

Usage note: Describes both intended and unintended cortical perforations in surgical contexts.

In Context

  • "Intraoperative fluoroscopy revealed a cortical breach requiring revision of the screw trajectory." — Operative complication note
  • "Care was taken to avoid cortical breach while advancing the intramedullary nail." — Surgical technique description

Also known as

cortical perforation cortical violation

Contrasted with

cortical integrity

Don't confuse with

cortical fracture thermal necrosis

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