Failure of femoral nailing in the elderly

✍ Scribed by P. Harrington; I. Sharif; H. Smyth

• Publisher: Springer
• Year: 1997
• Tongue: English
• Weight: 151 KB
• Volume: 116
• Category: Article
• ISSN: 1434-3916
• DOI: 10.1007/bf00393721

✦ Synopsis

Failure of fixation of a fracture of the mid-shaft of the femur in a 73-year-old male occurred 4 weeks after insertion of a reamed Grosse-Kempf nail. The oblique locking screw had cut out, despite having been correctly sited at the primary operation. A satisfactory result was obtained following open nailing using an AO nail. Two transverse proximal locking screws provide more certain fixation in osteoporotic bone of elderly patients. which had cut out proximally. The fracture fragments had displaced by telescoping around the nail (Fig. 1).

The patient was operated on the following day for revision nailing of the femur. The GK nail was removed and replaced with an AO nail with two proximal locking bolts. Traction with a transcondylar pin and open reduction allowed partial correction of the shortening. Partridge bands were used to hold the position, while the canal was reamed to accept a 14-mm AO nail (Fig. 2).

The patient was mobilised on the third postoperative day and has progressed to bony union without further intervention.