title: The ring butterfly fragment in diaphyseal fractures: its importance in flexible intramedullary nailing.
abstract: Ring butterfly fragment was described after it was noted to pose problems during insertion of flexible intramedullary nails. This fragment contains the entire circumference of the medullary canal or a substantial part of it. Once recognized preoperatively the fragment is reduced, providing a stable fracture configuration for fixation with flexible intramedullary nails. If the fragment is left displaced, it may lead to nonunion of the fracture; particularly after flexible intramedullary nailing of the tibia.
authors.affiliation: Division of Orthopaedic Surgery, Booth Memorial Medical Center, Flushing, New York 11355.
authors.forename: A M
authors.initials: AM
authors.lastname: Pankovich
authors.forename: S S
authors.initials: SS
authors.lastname: Shantharam
authors.forename: J I
authors.initials: JI
authors.lastname: Stein
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D013978:Tibial Fractures / Q000601:surgery*; D014945:Wound Healing