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Through-the-nail technique.

Eleftherios Tsiridis1, Amir Ali Narvani, Constantin Schizas

  • 1Whittington Hospital, London, United Kingdom.

Acta Orthopaedica Belgica
|September 13, 2005
PubMed
Summary
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This case study details managing a rare ipsilateral femur fracture with a pre-existing, broken intramedullary nail. The treatment focused on preserving the femoral head and achieving fracture union despite surgical challenges.

Area of Science:

  • Orthopedic Surgery
  • Trauma Management
  • Bone Fracture Repair

Background:

  • Ipsilateral femur neck and shaft fractures are uncommon and challenging injuries.
  • Concurrent survival of the femoral head and union of the femoral shaft are critical.

Observation:

  • A young male sustained a Garden IV femur neck fracture adjacent to a 10-year-old, broken intramedullary nail.
  • Surgical attempt to remove the nail was abandoned due to iatrogenic bone loss near the fracture site.

Findings:

  • The femur neck fracture was successfully fixed using three cancellous lag-screws in a triangular configuration.
  • Two screws were placed posterior to the nail, and one anterior screw was inserted through the nail.

Implications:

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  • This fixation technique offers a viable solution for complex femur fractures with pre-existing hardware.
  • Successful management highlights the importance of tailored surgical approaches in challenging orthopedic trauma cases.