Journal of Trauma and Injury

  • 제36권1호
  • /
  • Pages.65-69
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  • 2023
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
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Humeral intramedullary nail bending following trauma: a case report

  • Siem A. Willems (Department of Surgery, Haga Teaching Hospital) ;
  • Alexander P. A. Greeven (Department of Surgery, Haga Teaching Hospital)
  • 투고 : 2022.02.01
  • 심사 : 2022.04.21
  • 발행 : 2023.03.31
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초록

The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

키워드

과제정보

We appreciate all the resident doctors of the departments of surgery and anesthesia, the nursing staff in the operating room, intensive care unit and the surgical wards that assisted in the management of this patient.

참고문헌

  1. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691-7. https://doi.org/10.1016/j.injury.2006.04.130
  2. Singh J, Kalia A, Khatri K, Dahuja A. Resistant non-union of humerus after intramedullary nailing treated with locking compression plate with bone grafting with nail in situ and shoulder spica: a case report. J Orthop Case Rep 2017;7:80-3.
  3. Hierholzer C, Sama D, Toro JB, Peterson M, Helfet DL. Plate fixation of ununited humeral shaft fractures: effect of type of bone graft on healing. J Bone Joint Surg Am 2006;88:1442-7.
  4. Healy WL, White GM, Mick CA, Brooker AF Jr, Weiland AJ. Nonunion of the humeral shaft. Clin Orthop Relat Res 1987;(219):206-13.
  5. Wen H, Zhu S, Li C, Chen Z, Yang H, Xu Y. Antegrade intramedullary nail versus plate fixation in the treatment of humeral shaft fractures: an update meta-analysis. Medicine (Baltimore) 2019;98:e17952.
  6. Denies E, Nijs S, Sermon A, Broos P. Operative treatment of humeral shaft fractures: comparison of plating and intramedullary nailing. Acta Orthop Belg 2010;76:735-42.
  7. Giannoudis PV, Einhorn TA, Marsh D. Fracture healing: the diamond concept. Injury 2007;38 Suppl 4:S3-6. https://doi.org/10.1016/S0020-1383(08)70003-2
  8. Dunleavy ML, Burton A, Reid JS, Copeland CE. Surgical management of angulated femoral intramedullary nails associated with closed fractures: a systematic review of the literature. J Orthop 2020;21:314-20. https://doi.org/10.1016/j.jor.2020.06.005
  9. Kose O, Guler F, Kilicaslan OF, May H, Yuksel HY. Removal of a bent intramedullary nail in lower extremity: report of two cases and review of removal techniques. Arch Orthop Trauma Surg 2016;136:195-202. https://doi.org/10.1007/s00402-015-2360-1
  10. Sommer C, Babst R, Muller M, Hanson B. Locking compression plate loosening and plate breakage: a report of four cases. J Orthop Trauma 2004;18:571-7. https://doi.org/10.1097/00005131-200409000-00016
  11. Bek D, Demiralp B, Tunay S, Sehirlioglu A, Atesalp AS. Removal of a bent inflatable femoral nail: a case report. Acta Orthop Traumatol Turc 2008;42:211-3. https://doi.org/10.3944/AOTT.2008.211
  12. Kelsch G, Kelsch R, Ulrich C. Unreamed tibia nail (UTN) bending: case report and problem solution. Arch Orthop Trauma Surg 2003;123:558-62. https://doi.org/10.1007/s00402-003-0576-y
  13. Shen PC, Chen JC, Huang PJ, Lu CC, Tien YC, Cheng YM. A novel technique to remove bent intramedullary nail. J Trauma 2011;70:755-8. https://doi.org/10.1097/TA.0b013e31820009ea
  14. Kockesen TC, Tezer M, Tekkesin M, Kuzgun U. Traumatic femoral diaphyseal fracture and a bent intramedullary nail in a case with a completely healed femoral diaphyseal fracture. Acta Orthop Traumatol Turc 2002;36:177-80.
  15. Andrzejowski P, Giannoudis PV. The 'diamond concept' for long bone non-union management. J Orthop Traumatol 2019;20:21.