Open interlocked nailing without a targeting device or X-ray guidance for non-union of the femur: a case series

Abstract

From October 2005 to August 2007, we operated on six patients who had femoral non-unions and performed interlocked intramedullary nailing without X-ray guidance or a targeting device. There were three fractures of the distal femur, two fractures of the mid-shaft and one of the proximal femur. Fatigue failure of a non-interlocked Kuntscher nail and one nail migration were the presenting features in two patients. The presence of sclerosis of the bone ends in four cases and a need for cancellous bone grafts at the site of non-union in all patients made wide dissection and open reduction unavoidable. There was a limb length discrepancy in all patients before surgical intervention. Partial weight bearing was commenced at 6 weeks post-operation. There was no case of wound infection. There was no misplaced screw. Minimum range of knee flexion was 105° at 2 months post-operation. These early results call for a closer look at this cheap, safe and effective means of handling femoral non-union in third world societies where there is paucity of instrumentation and implants for interlocked nailing.

Transplantal distal migration of a tibial küntscher nail: About a case at Sylvanus Olympia hospital of lime

“…KÜNTSCHER's non-locked intramedullary nail nailing is still used in our context because of its affordability, but exposes to complications such as rotational disorders, and nail migrations [6,[13][14][15] . These are often proximal to the femur and related to a small diameter nail [16][17][18][19] . Distal migration is rare.…”

Removal of locked intramedullary nails with the aid of bolts

“…2,3,[13][14][15] Interlocked intramedullary nailing offers greater advantage in fracture fixation. [14][15][16][17] Implant removal is one of the commonly performed orthopedic procedures. 9 union stress shielding, prevention of future bacterial colonization, avoidance of difficult surgery due to the potential for refracture or implant failure and the possibility of improving functional outcome.…”