Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Femur
Abstract number: 24562
EFFECTIVENESS OF A DOCKING NAIL IN TREATING A FEMORAL FRACTURE
AROUND THE SINKING STEM AFTER TOTAL HIP REPLACEMENT
Asuka KASAI 1 , Shunji NAKANO 1 , Risa UTSUNOMIYA 1 , Masaru NAKAMURA 1 ,
Takashi CHIKAWA 1 , Tateaki SHIMAKAWA 1 , Hideaki MIYASHI 2 , Hiroshi MIKAMI 2 ,
Ryo MIYAGI 3
1 Department of Orthopaedics, Tokushima Municipal Hospital, Tokushima, Japan,
Tokushima (JAPAN), 2 Department of Orthopaedics, Oekyo Hospital, Tokushima,
Japan, Yoshinogawa (JAPAN), 3 Department of Orthopaedics, Kaminaka Hospital,
Tokushima, Japan, Kaminaka (JAPAN)
During osteosynthesis, stable fixation is often difficult to achieve because elderly
patients have osteoporotic bone and most of the intramedullary space is occupied by
the metal stem implanted in the proximal femoral shaft. Therefore, we developed a
new surgical treatment for postoperative periprosthetic femoral fracture by using a
trimmed intramedullary nail, which we refer to as a docking nail. The patient, a 76years-old
woman, sustained a femoral shaft fracture around the sinking femoral
prosthesis after cementless total hip replacement which she had undergone 2 years
earlier. To treat the femoral fracture, the docking nail was cut to an appropriate
length and trimmed so that it adhered to the tip of stem, on the basis of the size and
shape of the stem as well as data obtained from preoperative radiographs. We then
performed the same procedure as osteosynthesis by using the conventional
supracondylar intramedullary nail in a retrograde manner. We did not open the
fracture site and connected the docking nail to the tip of the implanted stem to
maintain correct alignment. After the operation no immobilization was used, partial
weight bearing was allowed at 4 weeks, and full weight bearing at 12 weeks. Within 3
months, well-aligned bony union was observed without malunion or infection. The
woman did not experience any pain around the hip and fracture site during the followup
period of 12 months. The use of a docking nail is less invasive and simpler as
compared to other methods.
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