Fixation of a Peri-Implant Distal Femur Fracture Adjacent to Cephalomedullary Nail With Retrograde Intramedullary Nail in a Capacious Canal: A Case Report
Recommended Citation
Weaver M, Khan U, Chmielewski D, Swanson K, Best B, Afsari A. Fixation of a Peri-Implant Distal Femur Fracture Adjacent to Cephalomedullary Nail With Retrograde Intramedullary Nail in a Capacious Canal: A Case Report. JBJS Case Connect. 2026;16(1).
Document Type
Article
Publication Date
1-1-2026
Publication Title
JBJS Case Connect
Keywords
Humans, Female, Aged, Fracture Fixation, Intramedullary, Femoral Fractures, Bone Nails, Periprosthetic Fractures, Femoral Fractures, Distal
Abstract
CASE: A 75-year-old woman presented after a low-energy fall with a minimally displaced, extra-articular peri-implant distal femur fracture at the tip of a previously placed cephalomedullary nail. Her proximal femur was in native varus, and she was profoundly osteoporotic, resulting in a capacious distal femoral metaphyseal canal and a laterally positioned distal nail tip. Because her anatomy appeared to permit safe implant overlap without excessive canal "overstuffing," a retrograde femoral nail was inserted adjacent to the existing cephalomedullary nail using a percutaneous technique. She was mobilized weight bearing as tolerated. At approximately 1 year postoperatively, documentation noted painless full knee range of motion, intact distal vascular status, and continued safe wheelchair transfers.
CONCLUSION: In carefully selected patients with favorable anatomy, peri-implant distal femur fractures at the tip of a cephalomedullary nail may be stabilized with an overlapping retrograde femoral nail as one option alongside minimally invasive plating and other strategies.
Medical Subject Headings
Humans; Female; Aged; Fracture Fixation, Intramedullary; Femoral Fractures; Bone Nails; Periprosthetic Fractures; Femoral Fractures, Distal
PubMed ID
41678667
Volume
16
Issue
1
