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Fatigue Fracture of the Interlocking Nail in the Treatment of Femoral Shaft Fractures
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Jung Ryul Kim, Jin Ho Yoon
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J Korean Soc Fract 2003;16(2):163-168. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.163
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 Abstract
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- PURPOSE
To analyze clinical and mechanical factors of the fatigue fracture of the intramedullary nail in the treatment of the femoral shaft fractures and to consider preventive methods of fatigue fracture.
MATERIALS AND METHODS
We reviewed 12 patients of fatigue fractures of the intramedullary and were followed for a minimum one year. The site of fatigue fracture of the intramedullary nail was at fracture site in 10 cases, just proximal to proximal locking hole in one, and the most proximal of two distal locking holes in one. We analyzed type and diameter of broken nail, time from injury to fatigue fracture, causes of metal failure, and treatment results.
RESULTS
Intramedullary nails which had fatigue fracture were reamed AO nail in four cases, Grosse-Kempf nail in four, Russel-Taylor nail in three, and long Gamma nail in one. Time to fracture of implant was average 13.6 months (range, 6~30 months). All cases were treated by intramedullary nailing, and additional autogenous bone grafting was done in three cases. At an average duration of follow-up of 7.5 months (range, 5 to 10 months), all of the fractures had healed.
CONCLUSION
To prevent fatigue fracture of intramedullary nail, closed obervation for bony union, progressive weight bearing, and augmentation with autogenous bone grafting for comminuted fracture site should be needed.
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Metal Failure after Internal Fixation in the Treatment of Femur Mid-shaft Fractures
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Kyung Jin Song, Jang Yeub Jeon, Jin Ho Yoon, Myung Sik Park, Byung Yeon Hwang
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J Korean Soc Fract 2002;15(3):349-355. Published online July 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.3.349
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Abstract
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- PURPOSE
To evaluate the causative factors of metal failure after internal fixation, and to suggest more rational treatment guideline that can prevent metal failure in the mid-shaft femur fractures.
MATERIALS AND METHODS
A retrospective review of 17 cases, who were treated with internal fixation for the femur mid-shaft fracture was analyzed. We evaluated the cause of injury, fracture type and site, associated injury, used instruments, duration to metal failure, and complications.
RESULTS
The metal failure occurred on average 14.8 months after internal fixation. As extrinsic factors, early exercise and weight-bearing in 7 cases, slip down during ambulation in 4 cases, improper physical therapy in 3 cases and unknown cause in 3 cases were related to metal failure. Most metal failure were occurred at the initial fracture site in 12 cases. Other metal failure site were empty holes in 1 case and proximal area of fracture site in 1 case, and screw breakage in 3 cases.
CONCLUSION
Accurate preoperative evaluation of fracture site, fracture type and proper selection of instrument, and precise surgical technique will be essential for the prevention of metal failure.
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