scholarly journals New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
S. Jagernauth ◽  
A. J. Tindall ◽  
S. Kohli ◽  
P. Allen
Keyword(s):  
Female Patient ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Femoral Fracture ◽  
Fracture Site ◽  
Distal Interlocking ◽  
Nail Insertion ◽  
Derotation Osteotomy ◽  
Walking Difficulty

A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

scholarly journals Severe osteolysis and periprosthetic femoral fracture 45 years after acrylic hemiarthroplasty of the hip: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hisatoshi Ishikura ◽  
Masaki Nakamura ◽  
Kenta Matsuda ◽  
Takeyuki Tanaka ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Intramedullary Nail ◽  
Femoral Fracture ◽  
Periprosthetic Fracture ◽  
Plate Fixation ◽  
Sudden Onset ◽  
Fracture Site ◽  
Resection Arthroplasty ◽  
Periprosthetic Femoral Fracture ◽  
Left Femur

Abstract Background Hip arthroplasty using acrylic prosthesis was once conducted; however, it has now been abandoned because of early breakages and wear of material. Therefore, complications or revision surgeries due to the use of acrylic prostheses are becoming rare. Case presentation A 76-year-old woman presented with a sudden onset of severe pain in her left femur while walking. Radiographs revealed severe osteolysis and periprosthetic femoral fracture 45 years after the initial hemiarthroplasty using an acrylic prosthesis. We performed a Girdlestone resection arthroplasty by removing the prosthesis and fixing the fracture site using an intramedullary nail and metal plate. The patient was pain-free in her hip and leg 2 years and 9 months after the surgery. Although she walked with a cane or crutches, no postoperative complications were observed. Conclusions The combined use of an intramedullary nail and plate fixation with resection arthroplasty could offer acceptable results for patients with severe osteolysis and periprosthetic fracture after femoral head replacement using an acrylic prosthesis. Our report seems relevant because it not only reminds us of the significant steps made in the development of modern total hip arthroplasty; it also highlights one of the surgical options for severe osteolysis and periprosthetic fracture of the hip.

Metallurgical Failure Analysis of Intramedullary Nail Used for Femoral Fracture Stabilization

2016 ◽  
Vol 695 ◽  
pp. 178-182
Author(s):  
Brandusa Ghiban ◽  
Iulian Antoniac ◽  
Gheorghe Dan ◽  
Alexandru Ghiban ◽  
Razvan Ene
Keyword(s):  
Intramedullary Nail ◽  
Femoral Fracture ◽  
Microstructural Analysis ◽  
Femoral Fractures ◽  
Austenitic Stainless Steels ◽  
Longitudinal Section ◽  
Fracture Site ◽  
Fractographic Analysis ◽  
Fracture Stabilization ◽  
Tear Propagation

Currently orthopedics challenge is the use of intramedullary nails to straighten diaphyseal femoral fractures. In this paper it was conducted a case study on an intramedullary nail used for femoral fracture stabilization, in the case of one young patient. The evolution was unfavorable to the fracture site and the implant failed after three month of first surgical intervention. Intramedullary nail dimensions were 300mm length and 10mm in diameter. The following investigations were made in order to establish the failure causes: determination of the chemical composition through spectral analysis, macrostructural analysis using stereomicroscopy, optical microstructural analysis using optical microscopy, fractographic analysis using scanning electron microscopy. The final conclusions showed that the metallic biomaterial used for manufacturing the intramedullary nail was approximately an austenitic stainless steel AISI 316L, but with major microstructural defects. Macro-structural analysis revealed the presence of two zones of cracking, which are very rare at austenitic stainless steels. Also breaking with a fragile character has radial front tear propagation. In longitudinal section, cracks were evidenced due to the extraction operation and also the presence of corrosion products was shown. From fractographic analysis it was determined that intramedullary nail failure was predominantly through the mechanism of brittle fracture that took place at the point of maximum bending of the implant fragile.

scholarly journals Transtibial Amputation with Removal of the Tibial Intramedullary Nail: Hardware Removal in a Retrograde Manner

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Youn-Ho Choi ◽  
DoJoon Park
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Intramedullary Nail ◽  
Diabetic Foot ◽  
Patella Instability ◽  
Special Situation ◽  
Transtibial Amputation ◽  
Knee Amputation ◽  
Distal Interlocking ◽  
Nail Insertion

Transtibial amputation is the preferred strategy for treating a diabetic foot with an infection and necrosis. However, if a tibial intramedullary nail was previously inserted into the ipsilateral lower extremity, the nail must be removed to perform the transtibial amputation. In this special situation, the removal of the tibial intramedullary nail can cause various complications after transtibial amputation. We present a case and surgical technique report of a 46-year-old male with an uncontrolled diabetic foot with tibial intramedullary nail insertion. With the nail and ankle fixed by distal interlocking screws, a below-knee amputation was performed by removing the nail and the amputated limb together. This surgical method is expected to reduce postoperative complications such as infections and patella instability after the amputation of a diabetic foot.

scholarly journals EARLY OUTCOMES OF FLEXIBLE INTRAMEDULLARY NAILING IN PEDIATRIC SHAFT OF FEMUR FRACTURES

2021 ◽  
Vol 71 (6) ◽  
pp. 2157-60
Author(s):  
Muhammad Umair Hashmi ◽  
Muhammad Nadeem Ahsan ◽  
Babar Bakht Chughtai ◽  
Saqib Majeed
Keyword(s):  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Femur Fracture ◽  
Fracture Site ◽  
Medullary Canal ◽  
Femur Fractures ◽  
Flexible Intramedullary Nailing ◽  
Mean Diameter ◽  
Flexible Intramedullary Nail ◽  
Age Range

Objective: To study the early outcomes and complications of fixation of pediatric shaft of femur fractures using flexible intramedullary nail. Study Design: Prospective observational study. Place and Duration of Study: Orthopedic Department, Bahawal Victoria Hospital Bahawalpur, from Jan to Jun 2021. Methodology: Children between the ages of 5-11 years with shaft of femur fractures were included in the study. Fixation of fracture was done using elastic intramedullary nail. Final outcomes of fixation were observed using Flynn and Schwend Scoring System. Six-month follow-up was done in all cases. Data was analyzed using SPSS-20. Results: Total 70 cases having shaft of femur fracture were included in the study. Age range of cases was 5-11 years with mean age of 7.75 ± 1.66 years and mean weight of 24.44 ± 4.77 kilograms. Mean diameter of femur medullary canal was 7.48 ± 0.63 millimeters and mean diameter of flexible nail was 3.03 ± 0.26 millimeters. Mean post-operative period of radiological union of fracture was 8.57 ± 1.05 weeks. Per-operatively, fracture site was approached in 4 (5.7%) cases. Migration of nail was not seen in any case. Final outcomes according to Flynn and Shwend Score were excellent in 62 (88.5%), satisfactory in 7 (10%) and poor in 1 (1.4%) case. Conclusion: Fixation of shaft of femur fracture using flexible intramedullary nailing technique is safe and reliable with good outcomes among children between 5-11 years of age.

scholarly journals Are Cephalomedullary Nail Guides Accurate? A Case Report of an Unexpected Complication After Nailing an Intertrochanteric Femoral Fracture

2018 ◽  
Vol 9 ◽  
pp. 215145851875779
Author(s):  
Rayan Fairag ◽  
Fahad H. Abduljabbar ◽  
Alex Page ◽  
Ron Dimentberg
Keyword(s):  
Case Report ◽  
Carbon Fiber ◽  
Intramedullary Nailing ◽  
Hip Fractures ◽  
Femoral Fracture ◽  
Intraoperative Imaging ◽  
Unusual Complication ◽  
Cephalomedullary Nail ◽  
Lag Screw ◽  
Intertrochanteric Femoral Fracture

Intramedullary nailing is the mainstay of treatment for unstable intertrochanteric hip fractures. Various complications have been described with the use of these nails. We report an unusual complication whereby the lag screw completely missed the nail. We hypothesize that this previously unreported complication may be related to a specific flexible carbon fiber aiming device. Surgeon awareness and thorough intraoperative imaging are crucial to avoiding this complication.

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