Exchange nailing and medial wall reconstruction following implant failure in a subtrochanteric femoral fracture. (December 2021)

• Record Type: Journal Article
• Authors: Richardson, Philippa; Panteli, Michalis; Giannoudis, Peter V.
• Is Part Of: Trauma case reports. Volume 36(2021)
• Publication Date: 2021-12
• Subjects: Femur -- Non-union(s) -- Subtrochanteric -- Nail -- Revision; Wounds and injuries -- Periodicals; Traumatology -- Periodicals; 617.1005
• DOI: 10.1016/j.tcr.2021.100555
• Languages: English
• ISSNs: 2352-6440

Abstract

Abstract: Failure of fixation of subtrochanteric fractures has been reported in as high as 20% of cases. Several associations have been suggested to contribute to failed fixation. Discontinuity of the medial wall/column is considered to be one of the most significant risk factors for non-union and subsequent implant failure, especially if this defect is not addressed during the revision surgery. We present a case of failed fixation of a subtrochanteric fracture in an 86-year-old female where revision surgery paid special attention to restoring the medial wall continuity via bone grafting resulting in satisfactory union of the fracture. We advocate the necessity of reconstructing the medial column in similar cases in order to enhance healing and restore the biomechanical support of the subtrochanteric region.