Bifocal Bone Transport over a Preexisting Nail to Treat a Septic Femoral Shaft Nonunion

Intramedullary nailing is the method of choice for the treatment of most femoral shaft fractures. However, it is not always an easy procedure with predictable results as leg length discrepancy as well as rotational and angular malunion may occur. Lengthening over an intramedullary nail (IMN) has bec...

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Bibliographic Details
Published in:Case reports in orthopedic research 2019-08, Vol.2 (1-3), p.40-46
Main Authors: Tsibidakis, Haridimos, Guerreschi, Francesco, Fakhry, Fakher, Poli, Piero, Grion, Luca, Panou, Artemisia
Format: Article
Language:English
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Case Report
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Summary:Intramedullary nailing is the method of choice for the treatment of most femoral shaft fractures. However, it is not always an easy procedure with predictable results as leg length discrepancy as well as rotational and angular malunion may occur. Lengthening over an intramedullary nail (IMN) has become very common as it allows early removal of the external fixator. This report presents a case of an open femoral shaft fracture initially treated with an IMN and subsequently complicated by a septic nonunion. Union was obtained by bifocal bone transport with a circular external fixator over the preexisting nail without exchange or removal of the previously inserted IMN. In conclusion, the presence of an IMN supports osteotomy and regenerates bone during bone healing, prevents fracture and/or deformation of the regenerated bone, and reduces the time needed for the external fixator.
ISSN:2296-9373
2296-9373
DOI:10.1159/000501844