A Rehman, Ayoub Laghari.
Fracture of Femoral Neck During Intra Medullary Nailing of the Femur.
J Surg Pak Jan ;6(2):42-3.

Intra medullary nailing is the main stay in management of fracture of femur, because of high rate of union. In this report a fracture of femoral neck in a young male of 30 years due to technical error in infra, medullary nailing of the femur is presented.

A thirty year old man sustained closed fracture of the right femur in a road traffic accident. Three days after the fracture he underwent intra medullary nailing of the femur using ten millimeter intra medullary nail. During the procedure difficulty with penetration of the proximal part of the femur in the area of the piriform recess was noted and several large drill holes were made at the entry site, which resulted initially in the pin passing through the soft tissues medial to the fracture site. The pin was withdrawn and then directed more laterally. This resulted in the pin passing down the medullary canal, and the remainder of the nailing procedure was uneventful.

On the first post operative day the patient complained of excessive pain. Radiograph confirmed fracture of the femoral neck. The fracture apparently began superiorly in or adjacent to the entry site for the intra medullary nail.

The patient was maintained on crutches, with only light toetouch for two months. Then he was gradually started weight bearing. Radiographs taken six months after the intra medullary nailing showed healing of both the femoral fractures.

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