Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Femur
Abstract number: 26543
CASE REPORT: UNUSUAL CASE OF REFRACTURE OF THE FEMORAL SHAFT
IN A 16-YEAR OLD BOY
Christian GIESSAUF, Karl GRUBER
District hospital of Weiz, Austria, Weiz (AUSTRIA)
IntroductionDue to open growth plates fractures of the long bones in teenagers
represent a challenge for both the surgeon and the implant. Case ReportWe present
a 16-year old boy who sustained a left femoral shaft fracture due to a motorcycle
accident. Concomitantly, he had an open fracture of the left patella. He was normal
weight (body mass index 20.7) Plate osteosynthesis of the femoral shaft and fixation
of the patella with Kirschner wires and screws were performed the same day.
Radiographs were taken routinely every second week. The patient was free of
complaints 2 months after surgery. Under permission of full weight-bearing he
sustained a refracture of the femur and a breakage of the plate. The implant was
removed and the fracture was stabilized by intramedullary nailing. Seven months
later the patient presented with a re-fracture of the femur and a bending of the
intramedullary nail without having a proper accident. The nail was removed and after
delayed bone healing resolved by distal dynamic sampling the patient was able to
return to work 18 months after the first operation and reached his preinjury level of
activity 2 years after the initial operation.Discussion The initial operation was
performed by open reduction and internal fixation with plate osteosynthesis due to
open growth plates. No implant failure was detected and no reason for breakage of
the plate and bending of the nail was found. It still remains unclear weather the
patient concealed further accidents or untimely full weight-bearing.
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