Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur

We describe a rare case with breakage of gamma nail accompanied by nonunion of the original fracture and a subsequent new fracture in the ipsilateral femur. A 73-year-old woman suffered a subtrochanteric fracture of the femur, and the fracture was fixed with gamma nail at a previous hospital. Howeve...

Full description

Saved in:
Bibliographic Details
Main Authors: Takahiro Niikura, Sang Yang Lee, Yoshitada Sakai, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/534570
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832548448969162752
author Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
author_facet Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
author_sort Takahiro Niikura
collection DOAJ
description We describe a rare case with breakage of gamma nail accompanied by nonunion of the original fracture and a subsequent new fracture in the ipsilateral femur. A 73-year-old woman suffered a subtrochanteric fracture of the femur, and the fracture was fixed with gamma nail at a previous hospital. However, fracture reduction was not adequately achieved and a large gap remained between the fracture fragments. The fracture demonstrated atrophic nonunion 10 months after surgery, and autologous bone grafting was performed at the same hospital. Two months after the second surgery, a breakage of the nail at the distal screw hole was observed. Twenty-six months after the second surgery, the patient fell and a fracture occurred at the level of the nail breakage. The atrophic nonunion site and fresh fracture site were very close thus demonstrating a segmental fracture. We exchanged the original gamma nail with a long gamma nail and performed autologous bone grafting at the nonunion site. Both the fresh fracture site and the nonunion site obtained bony union. This tragic chain of events was caused by inappropriate initial treatment and replacing the nail to a longer nail and autologous bone grafting were effective as salvage surgery.
format Article
id doaj-art-1a888a5ffda543468c0a9086e8326e57
institution Kabale University
issn 1687-9627
1687-9635
language English
publishDate 2013-01-01
publisher Wiley
record_format Article
series Case Reports in Medicine
spelling doaj-art-1a888a5ffda543468c0a9086e8326e572025-02-03T06:13:56ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/534570534570Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral FemurTakahiro Niikura0Sang Yang Lee1Yoshitada Sakai2Kotaro Nishida3Ryosuke Kuroda4Masahiro Kurosaka5Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanWe describe a rare case with breakage of gamma nail accompanied by nonunion of the original fracture and a subsequent new fracture in the ipsilateral femur. A 73-year-old woman suffered a subtrochanteric fracture of the femur, and the fracture was fixed with gamma nail at a previous hospital. However, fracture reduction was not adequately achieved and a large gap remained between the fracture fragments. The fracture demonstrated atrophic nonunion 10 months after surgery, and autologous bone grafting was performed at the same hospital. Two months after the second surgery, a breakage of the nail at the distal screw hole was observed. Twenty-six months after the second surgery, the patient fell and a fracture occurred at the level of the nail breakage. The atrophic nonunion site and fresh fracture site were very close thus demonstrating a segmental fracture. We exchanged the original gamma nail with a long gamma nail and performed autologous bone grafting at the nonunion site. Both the fresh fracture site and the nonunion site obtained bony union. This tragic chain of events was caused by inappropriate initial treatment and replacing the nail to a longer nail and autologous bone grafting were effective as salvage surgery.http://dx.doi.org/10.1155/2013/534570
spellingShingle Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
Case Reports in Medicine
title Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
title_full Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
title_fullStr Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
title_full_unstemmed Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
title_short Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
title_sort nonunion with breakage of gamma nail and subsequent fracture in the ipsilateral femur
url http://dx.doi.org/10.1155/2013/534570
work_keys_str_mv AT takahironiikura nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur
AT sangyanglee nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur
AT yoshitadasakai nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur
AT kotaronishida nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur
AT ryosukekuroda nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur
AT masahirokurosaka nonunionwithbreakageofgammanailandsubsequentfractureintheipsilateralfemur