J Korean Orthop Assoc.  2014 Dec;49(6):485-489. 10.4055/jkoa.2014.49.6.485.

Surgical Treatment in Atypical Diaphyseal Femoral Fracture with Anterior and Lateral Bowing

Affiliations
  • 1Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea. hangugy@hanmail.net
  • 2Department of Orthopaedic Surgery, College of Medicine, Yonsei University, Seoul, Korea.

Abstract

In an atypical diaphyseal femoral fracture with marked anterior and lateral bowing, there are some obstacles in fixation of the fracture, such as difficulty in insertion of the intramedullary nail (IM nail) due to mismatch of the IM nail with the bow of the femur, iatrogenic fracture, nonunion due to angulation, and leg length discrepancy. We experienced a good result, which was achieved after fixation of the counterlateral curved IM nail; therefore, we report on this case with a review of the literature.

Keyword

femur shaft; atypical diaphyseal femoral fracture; anterior and lateral bowing; intramedullary nail

MeSH Terms

Femoral Fractures*
Femur
Leg

Figure

  • Figure 1 (A) Preoperative radiograph shows an atypical diaphyseal femur fracture. The radiographic features include a common location in the femoral shaft lesion, short oblique fracture configurations, absence of comminution, a medial spike (black arrow), and localized periosteal thickening of the lateral cortex (white arrow). (B, C) Uninjured femur (left side) has marked anterior and lateral bowing.

  • Figure 2 Expert Asian Femoral Nail (A2FN; Synthes, Solothurn, Switzerland) is designed having a proximal lateral band (A) and anterior curve (B).

  • Figure 3 (A, B) Using contralateral curved intramedullary nailing, the operation was performed. Radiographs of the femur taken four months after the operation show callus formation at the fracture site, diminished lateral bowing and gap of the fracture.


Reference

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