Tag Archives: intramedullary nail

Orthopedics, Print Release

PUBLISHED: The Use of a Magnetic Intramedullary Nail for Management of a Symptomatic Nonunion Following Shortening Osteotomy to Treat Leg-Length Discrepancy

The Use of a Magnetic Intramedullary Nail for Management of a Symptomatic Nonunion Following Shortening Osteotomy to Treat Leg-Length Discrepancy
Phillip T. Grisdela Jr, MD; Nishant Suneja, MD
Brigham and Women’s Hospital

This is the case of a 31-year-old female with a history of juvenile rheumatoid arthritis and uveitis who presented with a leg-length discrepancy and low back pain refractory to conservative management. She underwent a shortening osteotomy on her left femur around an intramedullary nail that went on to nonunion.

She underwent exchange nailing with a magnetic intramedullary nailing with autologous bone graft harvest from her affected femoral reamings. The magnetic intramedullary nail was extended 2 cm prior to insertion, and then implanted in the usual fashion with immediate compression in the operating room. Postoperatively the patient underwent a compressive program using the magnetic nail and went on to heal her osteotomy site.

Orthopedic Trauma, Orthopedics, Print Release

PUBLISHED: Retrograde Femoral Intramedullary Nail for a Midshaft Femoral Fracture with an Ipsilateral Subtrochanteric Fracture

Retrograde Femoral Intramedullary Nail for a Midshaft Femoral Fracture with an Ipsilateral Subtrochanteric Fracture
Jason P. Den Haese Jr.1; Michael J. Weaver, MD2
1Lake Erie College of Osteopathic Medicine
2Brigham and Women’s Hospital

This case illustrates a midshaft femoral fracture with an ipsilateral subtrochanteric fracture that is repaired with a retrograde femoral intramedullary nail technique. The annual incidence of midshaft femur fractures is approximately 10 per 100,000 person-years (most commonly low-energy falls in elderly females). Generally, these patients will present with pain, inflammation, and shortening of the leg.

Retrograde femoral intramedullary nail placement is one of the most prevalent methods for treatment. It was initially discovered in 1970 and refined in 1995 to have improved surgery time, bleeding, and postoperative adverse outcomes. This procedure has proven to be particularly beneficial in obese and non-ambulatory patients, and those with multisystem injuries; it also has shown some benefit in pregnant women due to decreased pelvic radiation exposure.

This case presents a woman with a femoral shaft fracture and an ipsilateral subtrochanteric fracture. Given this patient’s multiple ipsilateral femur fractures, it was favorable to intervene with a retrograde femoral intramedullary nail. The procedure was done in a supine position due to favorable imaging throughout the operation.