Tag Archives: nail

Orthopedic Trauma, Orthopedics, Print Release

PUBLISHED: Closed Cephalomedullary Nailing of a Diaphyseal Femur Fracture on a Fracture Table

Closed Cephalomedullary Nailing of a Diaphyseal Femur Fracture on a Fracture Table
Sarita Jamil1; Michael J. Weaver, MD2
1University of Central Florida College of Medicine
2Brigham and Women’s Hospital

Femoral fractures typically occur in two major settings: high-energy mechanisms related to trauma and low-energy mechanisms in insufficiency fractures observed in elderly patients with osteopenia. Patients present with pain, swelling, and limited range of motion.

Intramedullary nailing is the definitive surgical treatment for femoral fractures to allow secondary healing of bone. Such a repair is performed here on a patient with a diaphyseal femoral fracture. Surgeon preference was to perform a closed cephalomedullary nailing with the patient supine on a radiolucent fracture table for traction.

Orthopedic Trauma, Orthopedics, Print Release

PUBLISHED: Closed Cephalomedullary Nail Fixation of a Reverse Oblique Subtrochanteric Femoral Fracture in the Lateral Position

Closed Cephalomedullary Nail Fixation of a Reverse Oblique Subtrochanteric Femoral Fracture in the Lateral Position
Robert W. Burk IV, MS1; Michael J. Weaver, MD2
1Lake Erie College of Osteopathic Medicine
2Brigham and Women’s Hospital

Subtrochanteric femoral fractures commonly present in two different populations under very different circumstances. The elderly are commonly affected by low-energy events, such as a simple fall to the floor, while younger populations are more likely to be involved in high-energy events such as motor vehicle accidents. The majority of elderly injuries can be attributed to fragility fractures due to loss of bone density, but it is important to note an atypical fracture pattern that is present in those who have been taking bisphosphonates.

This video demonstrates an intramedullary fixation of a reverse oblique subtrochanteric femoral fracture in the lateral position. There is a classic deformity seen in subtrochanteric fractures due to strong muscular attachments in the region. In this video, we show that while the lateral position may be more difficult for obtaining x-rays, it provides natural external forces that make reduction and fixation easier.