Intramedullary cortical fragment in tibial nailing: push it, remove it or ignore it?
Keywords:
intramedullary cortical fragment, nailing, incarcerated free fragmentAbstract
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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