Valgus Malalignment Due to Internally Malrotated Trochanteric Nail Placement, with Rotational Malalignment in Femoral Shaft Segmental Fracture Fixation, an Underestimated Avoidable Technical Error: A Case Report

Hwang, Pil-Sung; Anuwar, N A; Khaw, Y C; Hadizie, D

doi:10.5704/moj.2003.011

Malays Orthop J

2020

DOI: 10.5704/moj.2003.011

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Valgus Malalignment Due to Internally Malrotated Trochanteric Nail Placement, with Rotational Malalignment in Femoral Shaft Segmental Fracture Fixation, an Underestimated Avoidable Technical Error: A Case Report

Pil-Sung Hwang

N A Anuwar

Y C Khaw

et al.

Abstract: Coronal malalignment due to malrotated trochanteric nail placement in femoral fracture fixation has never been reported. We present a case of a femoral segmental fracture fixed with a trochanteric nail, with a malrotated placement resulting in a valgus malaligned nail and femur, associated with a rotational malalignment. Knowledge of the modern nail design with proper intra-operative precautions, would avoid this underestimated technical error.

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2024

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Incidence of complications and functional outcomes following segmental femoral shaft fractures: a critical review of the literature

Vasilopoulou,

Karampitianis,

Chloros

et al. 2024

Eur J Orthop Surg Traumatol

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Background Although segmental femoral shaft fractures (SFSF) are very challenging to manage, there has been no critical evaluation of the current practices and outcomes. The aim of this study is to evaluate their characteristics, management trends, outcomes, and complications. Methods A literature search was conducted via the SCOPUS, Embase (via SCOPUS) and MEDLINE (via PubMed) between 1995 and 2023. Studies were included if they reported patient demographics, mechanism of injury, classification of fractures, associated injuries, type of management, outcomes, and complications. Exclusion criteria: only diaphyseal fractures were included and proximal and distal femoral fractures were excluded from this study. Results Overall, 22 studies met the inclusion criteria reporting on 313 patients. Mean age was 36.2 years with male–female ratio of 4.8 to 1. The majority were high-energy fractures secondary to road traffic accidents and 16% were open. The most commonly associated injuries included chest injury (27%) and lower leg fractures (24%). Treatment consisted of intramedullary nailing (IMN) (72%), plating (22%) or both combined (6%). Outcomes reported: good in 70%, fair in 10%, excellent in 19% and poor in 2% of cases. Mean time to union was 20 weeks. Complications are reported in 24% of cases, with most common delayed union (5%) and non-union (4%). Conclusion SFSF are high-energy fractures occurring most commonly in young males, are open in 16% of cases and have significant associated injuries. In their overwhelming majority, IMN is the mainstay of treatment. The expected outcome is generally good in 70% of cases, although not devoid of complications in 24% of cases and patients must be aware of this during the consent process.

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Incidence of complications and functional outcomes following segmental femoral shaft fractures: a critical review of the literature

Vasilopoulou,

Karampitianis,

Chloros

et al. 2024

Eur J Orthop Surg Traumatol

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Valgus Malalignment Due to Internally Malrotated Trochanteric Nail Placement, with Rotational Malalignment in Femoral Shaft Segmental Fracture Fixation, an Underestimated Avoidable Technical Error: A Case Report

Cited by 1 publication

References 4 publications

Incidence of complications and functional outcomes following segmental femoral shaft fractures: a critical review of the literature

Incidence of complications and functional outcomes following segmental femoral shaft fractures: a critical review of the literature

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