scholarly journals An Uncommon Complication of Arteriovenous Fistula Following Intramedullary Nail Distal Locking – A Case Report

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Yahav Levy ◽  
Guy Feldman ◽  
Yoram A Weil ◽  
Mahmoud Jammal
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Intramedullary Nail ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Unusual Complication ◽  
Screw Insertion ◽  
Distal Locking ◽  
Locking Screw ◽  
Medullary Nail

Introduction:An arterial pseudo aneurysm formation is an unusual complication following intramedullary nail distal locking screw insertion. During such surgical procedure, arterial laceration might damage the wall, allowing blood leakage into the soft- tissue surrounding. Only few records are available regarding such injuries. Case Report: A 19-year-old male diagnosed with femoral shaft fracture after a trauma event, was treated using Antegrade Long Intra-Medullary Nail with distal locking screw. Following post-operative serial blood count indicating a consistent decrease in his Haemoglobin levels, a Computed Tomography angiogram was performed and showed an arteriovenous fistula of the lateral superior geniculate artery. The artery was coiled, and haemoglobin levels were stabilized again. Conclusion: A distal interlocking screw should be carefully placed, including blunt dissection before the drilling and screw placement. In addition, blood counts were proved essential in routine. Keywords: Arteriovenous fistula, intramedullary nail distal locking, antegrade long intra-medullary nail.

scholarly journals Butterfly Fragment in the Femoral Shaft Fractures Treated by Intramedullary Nail: Do We Need to Reduce It or Not?

2020 ◽  
Author(s):  
Tayyar Kürşat Dabak ◽  
Osman Ci̇van ◽  
Hakan Özdemi̇r
Keyword(s):  
Intramedullary Nail ◽  
Fragment Size ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Variance Analysis ◽  
Gap Size ◽  
Femur Shaft Fracture ◽  
Femoral Shaft Fractures ◽  
Significant Difference ◽  
Femur Shaft

Abstract Background: Limited data is available regarding the effect of gap size, fragment size and position of fragment on union in fragmented femur shaft fracture. The aim of the study is to analyze the effect of these parameters on union and determine cut-off values that necessitate reduction of fragment. Methods: Total of 59 patients with fragmented femur shaft fracture were reviewed and the effect of fragment size, gap size and fragment position on union were evaluated on 3rd, 6th and 12th month graphies from medical record of patients. Union rate was determined due to Radiographic Union Score of Femur. Patients were divided into small gap ( 10 mm) or large gap (10 mm), reverse fragment or non-reverse fragment and small fragment (50 mm) or large fragment (50mm) groups. Kruskal–Wallis Variance Analysis and Mann Whitney U test was used for comparisons among groups. The post-hoc Mann Whitney U-Test with Bonferroni Correction was used when the Kruskal Wallis Variance Analysis determined a significant difference.Results: In comparison of union scores of groups in regarding gap size and fragment size, there was not significant difference between groups at 3rd, 6th and 12th months. Union scores in the 3rd month (p=0,011) and 6th month (p=0,039) were lower in the reverse group than non-reverse group. But there was not statistically significant difference between two groups at 12th month (p=0.819). There was no significant difference in union rates in respect to intramedullary nail types. There was an indirect correlation between age and mean union score at 12th month. Conclusions: we could not determine any cutoff value regarding gap width and fragment size in the treatment of the femoral shaft fractures by IMN. Although there was a tendency to decrease in union scores due to the increase in the gap size, any significant difference was not determined. Only the reverse position of fragment had an adverse effect on the union until 6th months but the union score of reverse group reached the result of the non-reverse group by 12th months.

scholarly journals The Cortical Step Sign Fails to Prevent Malrotation of a Nailed Femoral Shaft Fracture: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Taranjit Tung ◽  
Ted Tufescu
Keyword(s):  
Case Report ◽  
Intramedullary Nailing ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Rotational Deformity ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
Clinically Significant

Intramedullary nailing has become the treatment of choice for diaphyseal femur fractures. Malrotation is a well-recognized complication of femoral nailing. Various techniques including the cortical step sign (CSS) have been described to minimize iatrogenic rotational deformity during femoral nailing. We present a case in which the use of the CSS resulted in a clinically significant malrotation requiring revision.

scholarly journals Delayed superficial femoral artery pseudoaneurysm following distal femoral shaft fracture: A case report

2011 ◽  
Vol 27 (6) ◽  
pp. 242-246 ◽  
Author(s):  
Sheng-Pin Lo ◽  
Chih-Chiang Hsieh ◽  
Chyun-Yu Yang ◽  
Chii-Jeng Lin ◽  
Chih-Wei Chang ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Artery Pseudoaneurysm

scholarly journals Bifocal Bone Transport over a Preexisting Nail to Treat a Septic Femoral Shaft Nonunion

2019 ◽  
Vol 2 (1-3) ◽  
pp. 40-46
Author(s):  
Haridimos Tsibidakis ◽  
Francesco Guerreschi ◽  
Fakher Fakhry ◽  
Piero Poli ◽  
Luca Grion ◽  
...  
Keyword(s):  
Bone Healing ◽  
External Fixator ◽  
Intramedullary Nail ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Bone Transport ◽  
Leg Length ◽  
Femoral Shaft Fractures ◽  
Circular External Fixator

Intramedullary nailing is the method of choice for the treatment of most femoral shaft fractures. However, it is not always an easy procedure with predictable results as leg length discrepancy as well as rotational and angular malunion may occur. Lengthening over an intramedullary nail (IMN) has become very common as it allows early removal of the external fixator. This report presents a case of an open femoral shaft fracture initially treated with an IMN and subsequently complicated by a septic nonunion. Union was obtained by bifocal bone transport with a circular external fixator over the preexisting nail without exchange or removal of the previously inserted IMN. In conclusion, the presence of an IMN supports osteotomy and regenerates bone during bone healing, prevents fracture and/or deformation of the regenerated bone, and reduces the time needed for the external fixator.

Hoffa Fragment Associated with a Femoral Shaft Fracture: A Case Report

2006 ◽  
Vol os-88 (10) ◽  
pp. 2270-2274 ◽  
Author(s):  
R. Miyamoto ◽  
E. Fornari ◽  
N. C. Tejwani
Keyword(s):  
Case Report ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture
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