Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Dec 23:37:100585.
doi: 10.1016/j.tcr.2021.100585. eCollection 2022 Feb.

Management of femoral non-union with post-traumatic bone defect using second-generation PRECICE® nail - A case report

Victor Lu  1 , James Zhang  1 , Matija Krkovic  2
Affiliations
Case Reports

Management of femoral non-union with post-traumatic bone defect using second-generation PRECICE® nail - A case report

Victor Lu et al. Trauma Case Rep. .

Abstract

The management of post-traumatic bone defects with non-union remains a surgical challenge. Current techniques are often fraught with complications, posing a functional, economical, and psychological challenge for the patient. A 57 year-old gentlemen suffered an open femoral fracture after a motorcycle accident. Having previously undergone open reduction internal fixation, he presented to us with atrophic non-union and bone defects, which were simultaneously treated with a second-generation PRECICE nail. Our treatment protocol was based on the strain theory, and involved initial distraction by ~5 mm at the non-union site, compression of the non-union site, followed by distraction osteogenesis at the non-union site. The patient achieved union and the initially planned limb lengthening regime was achieved with minimal complications. Self-lengthening, magnetically-driven PRECICE nails can successfully restore union and manage limb length discrepancies with reasonable patient satisfaction and minimal complications.

Keywords: Fracture; Limb lengthening; Osteogenesis; Trauma.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
a: AP X-ray of broken distal locking screws, non-union with limited callus formation. b: Lateral X-ray of broken distal locking screws, non-union with limited callus formation. c: AP X-ray showing the leg length discrepancy before PRECICE nail insertion. d: AP X-ray of distraction osteogenesis but no consolidation yet. e: Lateral X-ray of distraction osteogenesis but no consolidation yet. f: AP X-ray of consolidation and union. g: Lateral X-ray of consolidation and union.
Fig. 2
Fig. 2
Timeline of events.
See this image and copyright information in PMC

References

    1. Hood R.W., Riseborough E.J. Lengthening of the lower extremity by the Wagner method. A review of the Boston Children's Hospital experience. J. Bone Joint Surg. Am. 1981 Sep;63(7):1122–1131. - PubMed
    1. Perren S.M. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J. Bone Joint Surg. Br. 2002 Nov;84(8):1093–1110. doi: 10.1302/0301-620x.84b8.13752. - DOI - PubMed
    1. Barakat A., Schilling W.H.K., Sharma S., Guryel E., Freeman R. Chronic osteomyelitis: a review on current concepts and trends in treatment. Orthop. Trauma. 2019 April;33(3):181–187. doi: 10.1016/j.mporth.2019.03.005. - DOI
    1. Lu V., Zhang J., Zhou A., Krkovic M. Management of post-traumatic femoral defects with a monorail external fixator over an intramedullary nail [published online ahead of print, 2021 Aug 6] Eur J Orthop Surg Traumatol. 2021:1–8. doi: 10.1007/s00590-021-03082-1. - DOI - PMC - PubMed
    1. Iacobellis C., Berizzi A., Aldegheri R. Bone transport using the ilizarov method: a review of complications in 100 consecutive cases. Strateg. Trauma Limb Reconstr. 2010 Apr;5(1):17–22. doi: 10.1007/s11751-010-0085-9. - DOI - PMC - PubMed

Publication types

LinkOut - more resources