Flexible Titanium Intramedullary Nail Displacement After Magnetic Resonance Imaging

A previously healthy 7-year-old boy presented with midshaft radius and ulna malunion after 8 weeks of nonsurgical treatment. He underwent open reduction and internal fixation of both bones with titanium alloy nails and was placed in a long arm cast. Four weeks after surgery, the patient underwent sedated brain MRI and woke up from anesthesia with elbow pain. On cast removal, the ulnar flexible nail was noted to have displaced proximally by 1.5 cm.

Despite meeting American Society for Testing and Materials standards, untethered titanium orthopaedic implants are at risk of clinically significant displacement in the early postoperative period.