Retrieval of a Broken Intramedullary Nail after Refracture of Femoral Shaft: A case report

1997 ◽  
Vol 10 (2) ◽  
pp. 401
Author(s):  
Yung Khee Chung ◽  
Jung Han Yoo ◽  
Yong Wook Park ◽  
Ji Dong Lee
2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Yahav Levy ◽  
Guy Feldman ◽  
Yoram A Weil ◽  
Mahmoud Jammal

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.


2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Amr A. Abdelgawad ◽  
Enes Kanlic

Nonunion of long bones fixed with nails may result in implant failure. Removal of a broken intramedullary nail may be a real challenge. Many methods have been described to allow for removal of the broken piece of the nail. In this paper, we are reviewing the different techniques to extract a broken nail, classifying them into different subsets, and describing a new technique that we used to remove a broken tibial nail with narrow canal. Eight different categories of implant removal methods were described, with different methods within each category. This classification is very comprehensive and was never described before. We described a new technique (hook captured in the medulla by flexible nail introduced from the locking hole) which is a valuable technique in cases of nail of a small diameter where other methods cannot be used because of the narrow canal of the nail. Our eight categories for broken nail removal methods simplify the concepts of nail removal and allow the surgeon to better plan for the removal procedure.


2020 ◽  
Author(s):  
Tayyar Kürşat Dabak ◽  
Osman Ci̇van ◽  
Hakan Özdemi̇r

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.


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