Surgical Treatment in Atypical Diaphyseal Femoral Fracture with Anterior and Lateral Bowing

Hyun Cheol Oh; Seong Jin Park; Han Kook Yoon

doi:10.4055/jkoa.2014.49.6.485

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Oh, Park, and Yoon: Surgical Treatment in Atypical Diaphyseal Femoral Fracture with Anterior and Lateral Bowing

Case Report

Journal of the Korean Orthopaedic Association 2014; 49(6): 485-489.

Published online: 30 December 2014

DOI: https://doi.org/10.4055/jkoa.2014.49.6.485

Surgical Treatment in Atypical Diaphyseal Femoral Fracture with Anterior and Lateral Bowing

Hyun Cheol Oh, M.D., Seong Jin Park, M.D.^*, Han Kook Yoon, M.D.

Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea.

^*Department of Orthopaedic Surgery, College of Medicine, Yonsei University, Seoul, Korea.

Correspondence to: Han Kook Yoon, M.D. Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 410-719, Korea. TEL: +82-31-900-0540, FAX: +82-31-900-0343, hangugy@hanmail.net

Received 29 January 2014 Revised 20 May 2014 Accepted 17 June 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In an atypical diaphyseal femoral fracture with marked anterior and lateral bowing, there are some obstacles in fixation of the fracture, such as difficulty in insertion of the intramedullary nail (IM nail) due to mismatch of the IM nail with the bow of the femur, iatrogenic fracture, nonunion due to angulation, and leg length discrepancy. We experienced a good result, which was achieved after fixation of the counterlateral curved IM nail; therefore, we report on this case with a review of the literature.

Keywords: femur shaft, atypical diaphyseal femoral fracture, anterior and lateral bowing, intramedullary nail

Figures and Tables

Figure 1

(A) Preoperative radiograph shows an atypical diaphyseal femur fracture. The radiographic features include a common location in the femoral shaft lesion, short oblique fracture configurations, absence of comminution, a medial spike (black arrow), and localized periosteal thickening of the lateral cortex (white arrow). (B, C) Uninjured femur (left side) has marked anterior and lateral bowing.

Figure 2

Expert Asian Femoral Nail (A2FN; Synthes, Solothurn, Switzerland) is designed having a proximal lateral band (A) and anterior curve (B).

Figure 3

(A, B) Using contralateral curved intramedullary nailing, the operation was performed. Radiographs of the femur taken four months after the operation show callus formation at the fracture site, diminished lateral bowing and gap of the fracture.

References

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