Management of Pathological Femoral Refracture in a Child using Flexible Intramedullary Nail: A Case Report

Abstract

Simple Bone Cysts (SBCs) are benign, fluid-filled lesions primarily located in the metaphysis of long bones in children and adolescents. Depending on the clinical situation, management is performed, but the ultimate goal is to minimise surgical complications. Hereby, the authors present a case report presents the management of a seven-year-old male with a pathological refracture of the subtrochanteric region of the right femur due to an SBC. The patient presented with pain, swelling, and inability to bear weight on the affected limb. Diagnostic evaluation revealed a fracture in the subtrochanteric region along with a lytic, expansile lesion at the fracture site. The patient had a history of a similar fracture three years prior. Treatment involved closed reduction and internal fixation with two Flexible Intramedullary Nails (FIN), followed by immobilisation with a unilateral hip spica cast for six weeks. Follow-up radiographs showed satisfactory fracture reduction and signs of resolution of the bone cyst. The patient demonstrated good functional outcomes and successful management of the pathological refracture. The present case report contributes to the existing literature on the management of pathological refractures in paediatric patients and highlights the effectiveness of FINs as a treatment option in such cases.

Keywords

• paediatric patient
• simple bone cyst
• subtrochanteric femur