Periprosthetic fracture around intramedullary magnetic femoral nail: Management and case report

Abstract

Background: The intramedullary magnetic nail is an advanced technique in limb lengthening surgery, offering precise bone healing with minimal soft tissue disruption. However, increased use has led to a rise in periprosthetic fractures, and no standardized treatment protocols exist. This case report presents an innovative approach to managing such fractures without interrupting the limb lengthening process. Case report: A 21-year-old male with a 120mm limb length discrepancy, due to childhood osteomyelitis, underwent limb lengthening surgery with an intramedullary magnetic femoral nail. Twelve days postoperatively, he sustained a periprosthetic fracture around the proximal screws of the nail following a fall. We opted to continue the lengthening therapy by securing the fracture with a proximal femoral plate using one of the nail's screws. This approach allowed uninterrupted lengthening therapy. Follow-up confirmed stable fixation and successful limb lengthening, achieving an 80mm gain and reducing the discrepancy to 40mm. Conclusion: This case demonstrates a novel strategy for managing periprosthetic fractures during limb lengthening with intramedullary magnetic nails. By integrating the nail's proximal screw with a fixation plate, we enabled continued lengthening therapy and minimized additional surgical interventions. This approach underscores the need for further research to establish standardized protocols for managing such complications.

Keywords

• Intramedullary magnetic femoral nail
• Periprosthetic fracture
• Limb lengthening