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Symptoms indicating imminent breakage of a femoral interlocking nail: a case report.

Pan K, Chan W - Malays Orthop J (2013)

Bottom Line: Fractures of the femoral shaft treated with interlocking nails will ultimately result in breakage of the nail if the bone does not unite.The femur did not unite and the nail subsequently broke.Femur nonunion, interlocking nail, symptoms before breakage of nail.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Universiti Malaysia Sarawak, Kuching, Malaysia.

ABSTRACT

Unlabelled: Fractures of the femoral shaft treated with interlocking nails will ultimately result in breakage of the nail if the bone does not unite. Further management requires removal of the broken nail which may be a difficult process for the distal segment. If we can identify the symptoms just before the nail breaks, an exchange nailing becomes much easier. We present a patient with fibromatosis who underwent repeated surgery as well as radiotherapy at the age of 16. Six years later, she had a pathological fracture of the upper third of the femur for which an interlocking nail was inserted. The femur did not unite and the nail subsequently broke. Over a period of 12 years, three nails broke and had to be replaced. Two to 3 months before each breakage, the patient experienced the same set of symptoms for each episode. Knowing that her fracture was not going to heal will now alert us to do an exchange nailing before the nail broke again. It is well known that where there is evidence of non-union, pre-emptive treatment is necessary before implant failure.

Key words: Femur nonunion, interlocking nail, symptoms before breakage of nail.

No MeSH data available.


Related in: MedlinePlus

: Bone grafting done in 2002 when the bone did not unite.
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F2c: : Bone grafting done in 2002 when the bone did not unite.

Mentions: A year after the last radiotherapy treatment (6 years afterpresentation) in 2000, the femur fractured spontaneously at theshaft (Figure 2a) and this was treated with a Targoninterlocking nail. (Figure 2b) Bone grafting was done when ithad not united 20 months later. (Figure 2c) Periodic followupdid not document union. In 2007, seven years after the nailwas inserted, it broke at the nonunion site. Three months priorto the breakage, she experienced needling, intermittent pain(like ant bites) at the nonunion site. It was worse at night andon rainy days, and also after prolonged standing and walking.This progressively worsened until a few days before breakagewhen it became most severe on standing up from a sittingposition. At the point of breakage, there was a sudden, severepain and inability to bear weight, followed by swelling andwarmth over the thigh. The patient was then brought to thehospital where an radiograph confirmed a broken nail. Anexchange nailing was done a few days later.


Symptoms indicating imminent breakage of a femoral interlocking nail: a case report.

Pan K, Chan W - Malays Orthop J (2013)

: Bone grafting done in 2002 when the bone did not unite.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4322138&req=5

F2c: : Bone grafting done in 2002 when the bone did not unite.
Mentions: A year after the last radiotherapy treatment (6 years afterpresentation) in 2000, the femur fractured spontaneously at theshaft (Figure 2a) and this was treated with a Targoninterlocking nail. (Figure 2b) Bone grafting was done when ithad not united 20 months later. (Figure 2c) Periodic followupdid not document union. In 2007, seven years after the nailwas inserted, it broke at the nonunion site. Three months priorto the breakage, she experienced needling, intermittent pain(like ant bites) at the nonunion site. It was worse at night andon rainy days, and also after prolonged standing and walking.This progressively worsened until a few days before breakagewhen it became most severe on standing up from a sittingposition. At the point of breakage, there was a sudden, severepain and inability to bear weight, followed by swelling andwarmth over the thigh. The patient was then brought to thehospital where an radiograph confirmed a broken nail. Anexchange nailing was done a few days later.

Bottom Line: Fractures of the femoral shaft treated with interlocking nails will ultimately result in breakage of the nail if the bone does not unite.The femur did not unite and the nail subsequently broke.Femur nonunion, interlocking nail, symptoms before breakage of nail.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Universiti Malaysia Sarawak, Kuching, Malaysia.

ABSTRACT

Unlabelled: Fractures of the femoral shaft treated with interlocking nails will ultimately result in breakage of the nail if the bone does not unite. Further management requires removal of the broken nail which may be a difficult process for the distal segment. If we can identify the symptoms just before the nail breaks, an exchange nailing becomes much easier. We present a patient with fibromatosis who underwent repeated surgery as well as radiotherapy at the age of 16. Six years later, she had a pathological fracture of the upper third of the femur for which an interlocking nail was inserted. The femur did not unite and the nail subsequently broke. Over a period of 12 years, three nails broke and had to be replaced. Two to 3 months before each breakage, the patient experienced the same set of symptoms for each episode. Knowing that her fracture was not going to heal will now alert us to do an exchange nailing before the nail broke again. It is well known that where there is evidence of non-union, pre-emptive treatment is necessary before implant failure.

Key words: Femur nonunion, interlocking nail, symptoms before breakage of nail.

No MeSH data available.


Related in: MedlinePlus