Malunited Femur Shaft with Broken K-Nail In Situ with Medial Compartment Knee Arthritis: Deformity Correction and...

Malunited femur shaft fractures with associated deformities can lead to secondary knee osteoarthritis, often necessitating total knee replacement. Correcting these deformities can offload the knee joint and preserve function.

A 53-year-old male presented with a 14-year history of malunited right femur shaft fracture, complicated by a broken K-nail and a 23° varus deformity. He complained of medial knee pain for the past 6 months, with a VAS score of 7. Radiographs revealed Grade 3 medial compartment osteoarthritis. Initially advised total knee replacement, the patient opted for deformity correction with realignment. Surgical management involved two-level femoral osteotomy, implant removal, and fixation with interlocking intramedullary nailing. Post-operative imaging showed normal alignment and significant opening of the medial joint space. The patient's pain decreased to a VAS score of 3, and he began partial weight-bearing on the second post-operative day.

Deformity correction through osteotomy and realignment can alleviate knee symptoms and prevent further degenerative changes, thereby preserving the knee joint and avoiding total knee replacement. This approach offers a functional solution for patients with malunited femur fractures and knee arthritis, improving clinical outcomes and quality of life.