Modified Use of Humerus Nail for Management of Tibia Diaphyseal Fracture - Rare Case Report

There have been very few cases of intramedullary (IM) nailing for tibia shaft fracture using a humerus nail. We present to you a unique case of humerus nail used in tibia shaft fracture in a short-stature patient.

A 26-year-old female, was brought to our emergency room, she sustained trauma to her left leg while she was walking on the road hit by an automobile (pedestrian injury) with complaints of pain and swelling in her left leg. She has a family history of short stature. X-ray suggested of left tibia diaphyseal fracture with a left calcaneum fracture (undisplaced). Preoperatively, tibia length came out to be 22 cm. The shortest tibia nail available is 26 cm. Hence, the plan was to do IM humerus nailing. Closed reduction with internal fixation was done with a similar method as in tibia nailing. Titanium nail of size 8 mm × 22 cm was used. In the humerus nail, the bend is lateral, which was kept posteriorly as Herzog bends in the tibia nail. Postoperatively, patient was given below knee slab with nil weight bearing for 6 weeks.

Use of IM humerus nailing in tibia diaphyseal fracture fixation is possible. It provides rotational stability, leg length control, early mobilization and is also available in smaller sizes. Tibial fracture fixation with humeral nails in patients with short limb lengths is one of the possible options with satisfactory outcomes.