Intramedullary cortical fragment in tibial nailing: push it, remove it or ignore it?

Luigi Branca Vergano; Vito Prezioso; Mauro Monesi

doi:10.23750/abm.v92iS3.11714

Intramedullary cortical fragment in tibial nailing: push it, remove it or ignore it?

Authors

Luigi Branca Vergano U.O. Ortopedia e Traumatologia, Ospedale M. Bufalini, Cesena (FC)
Vito Prezioso
Mauro Monesi

DOI: https://doi.org/10.23750/abm.v92iS3.11714

Keywords:

intramedullary cortical fragment, nailing, incarcerated free fragment

Abstract

Intramedullary nailing of long bones is a safe procedure, with excellent long-term results. Even in apparently simple fractures, many complications may arise. Incarceration of a cortical fragment in the medullary canal is a fearsome situation, which may lead to severe complications and, consequently, poor outcomes. The surgeon should be aware of this risk and, after careful analysis of the pre-operative imaging, must remove or, at least, disengage the fragment from the medullary canal.

References

Eastman JG, Firoozabadi R, Cook LE, Barei DP. Incarcerated Cortical Fragments in Intramedullary Nailing. Orthopedics. 2016 May 1;39(3):e582-6. doi: 10.3928/01477447-20160414-04. Epub 2016 Apr 18. PMID: 27088352

Berg EE. Technical problems caused by comminuted cortical free fragments during intramedullary rodding: case reports. J Trauma. 1994 May;36(5):749-51. doi: 10.1097/00005373-199405000-00029. PMID: 8189483

Nag S, Lall H, Jain VK, Bansal P, Khare R, Mittal D. Intramedullary bone fragment obstructing passage of reaming guide wire with iatrogenic fractured tibia. Orthopedics. 2010 Feb;33(2):119-21. doi: 10.3928/01477447-20100104-24. PMID: 20192151.

Rainer W, Hake ME, Mauffrey C, Hak DJ. Intramedullary cortical fragments: Recognition and techniques to permit safe nailing. Injury. 2015 Dec;46(12):2502-6. doi: 10.1016/j.injury.2015.08.019. Epub 2015 Aug 19. PMID: 26319207.

Rajappa S, Kumar NS. Unusual complication following intramedullary nailing of tibia: a case report. Cases J. 2009 Sep 14;2:7343. doi: 10.4076/1757-1626-2-7343. PMID: 19918520; PMCID: PMC2769350.

M. Rodger, R. Atkins. Intra-articular fragment extrusion during tibialintramedullary nailing. Injury Extra (2008)39, 134-136

Salamon M, Finkemeier CG. Intramedullary bone fragment preventing passage of reaming guide wire. Am J Orthop (Belle Mead NJ). 2007 Sep;36(9):492-3. PMID: 17948154

Sabat D, Wangchuk T, Dhal A. Inadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing. Chin J Traumatol. 2014 Apr 1;17(2):118-20. PMID: 24698584

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Published

26-07-2021

Issue

Vol. 92 No. S3 (2021): Vol. 92 Suppl. 3 (2021): Advances in Orthopaedics, Traumatology and Rehabilitation - SERTOT: Guest Editors: Francesco Pogliacomi, Paolo Di Benedetto

Section

SERTOT 1: Case Reports

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How to Cite

Branca Vergano L, Prezioso V, Monesi M. Intramedullary cortical fragment in tibial nailing: push it, remove it or ignore it?. Acta Biomed. 2021;92(S3):e2021012. doi:10.23750/abm.v92iS3.11714

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