Abstract
BackgroundThis case report describes the mechanical failure of a femoral lengthening nail in order to allow early recognition and prevent its occurrence.Case presentationA femoral lengthening nail was used to achieve goal distraction length over eight weeks and sustained a mechanical failure during progressive weightbearing. Re-distraction was attempted with subsequent non-weight-bearing status. Although the patient was not able to attain the original goal length, radiographs demonstrated stable shortening of the patient’s right lower extremity along with early signs of incomplete regenerate bone. She eventually received exchange nailing with bone graft.ConclusionPost-operative protocol and weight-bearing status should be further researched and standardized after re-evaluating the mechanical stiffness of the intramedullary nail construct.
Highlights
This case report describes the mechanical failure of a femoral lengthening nail in order to allow early recognition and prevent its occurrence.Case presentation: A femoral lengthening nail was used to achieve goal distraction length over eight weeks and sustained a mechanical failure during progressive weightbearing
Congenital and acquired leg length discrepancy have often been treated by distraction osteogenesis, traditionally with external fixation frames
Intramedullary Nail (IMN) lengthening devices have been developed to allow limb lengthening with the advantages of intramedullary fixation while avoiding the known complications of external fixation
Summary
Congenital and acquired leg length discrepancy have often been treated by distraction osteogenesis, traditionally with external fixation frames. The patient stood 1.6 m and weighed 64.8 kg, with a calculated Body Mass Index (BMI) of 25.3 She acquired a leg length discrepancy of 30 mm, right shorter than left, had right hip pain, walked with a limp and complained of symptomatic hardware about her hip (Fig. 1). Ten days post-operatively, she followed up with uncomplicated healing wounds to begin her lengthening, 1 mm per day for a goal of 30 mm total lengthening She was followed weekly with physical exams and plain film radiographs (Fig. 3). The patient reported increased pain in her right thigh and felt that her right leg had shortened On physical exam, she was grossly 2 cm short on her right lower extremity with tenderness to palpation over the distal interlocking screw.
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