Failure of intramedullary femoral nail with segmental breakage of distal locking bolts: a case report and re- view of the literature

Abstract

【Abstract】Breakage of locking bolts is an impor- tant cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the distal locking hole. Here we report an unusual case of intramedul- lary femoral nail failure with segmental breakage of both the distal locking bolts. Such a scenario usually complicates further management. We successfully managed this case with exchange nailing without bone grafting. Here we briefly reviewed the literature regarding such an unusual presenta- tion and discussed in detail the possible etiology of such a presentation and the management options when facing such a complex situation. Key words: Femoral fractures; Bone screws; Frac- ture fixation, intramedullary; Fracture healing