Endoscopic resection of scar tissues and bone graft with an intramedullary nail left in situ for distal femoral nonunion after nailing: A case report

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 28; no. 3; p. 2309499020958203
• Main Authors: Tsujii, Masaya, Odake, Kazuya, Nishimura, Akinobu, Nishimura, Makoto, Sudo, Akihiro
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2020; SAGE Publishing
• Subjects: Aged; Bone Nails - adverse effects; Bone Transplantation - adverse effects; Cicatrix - diagnosis; Cicatrix - etiology; Cicatrix - surgery; Femoral Fractures - diagnosis; Femoral Fractures - surgery; Femur; Fracture Fixation, Intramedullary - adverse effects; Fractures, Ununited - diagnosis; Fractures, Ununited - surgery; Humans; Male; Postoperative Complications; Radiography; Treatment Outcome; bone graft; pseudoarthrosis; nonunion; endoscopic surgery; fracture
• ISSN: 2309-4990; 1022-5536; 2309-4990
• DOI: 10.1177/2309499020958203

Femoral shaft nonunion after the intramedullary nailing has been successfully treated with advances in surgical technique. Nonetheless, the techniques cause morbidity to periosteum at the fracture site. We report the case of a 67-year-old man who underwent endoscopic surgery for refractory nonunion following the fracture of the distal femoral shaft, despite two fixations using an interlocking nail. In addition, the patient had uncontrolled diabetic mellitus. Endoscopy allowed us to acquire a clear view of the nonunion site, in which the resection of scar tissues and the packing of the cancellous bone were performed. At the final follow-up, bone healing was observed, and the patient was able to return to normal daily and social activity.