title: Femoral head avascular necrosis after interlocking nail of a femoral shaft fracture in a male adult: a case report.
abstract: Reamed interlocking nail through the piriformis fossa remains the golden standard for treatment of femoral shaft fracture. Fracture healing rates are 95-99%, and infection rates less than 1% (Clawson et al. in J Bone Joint Surg (Am) 53:681-692, 1971; Winquist et al. in J Bone Joint Surg (Am) 66:529-539, 1984; Brumback et al. in J Bone Joint Surg (Am) 70:1453-1462, 1988). Previous reports recognize avascular necrosis of the femoral head as a complication of antegrade interlocking nail in the adolescent (Beaty et al. in J Pediatr Orthop 14:178-183, 1994; Mileski et al. in J Bone Joint Surg (Am) 76:1706-1708, 1994; O'Malley et al. in J Pediatr Orthop 15:21-23, 1995; Buckaloo et al. in J Southern Orthop Assoc 6(2):97-100, 1997). This report describes a male adult who developed avascular necrosis of the femoral head after an open antegrade interlocking nail of a proximal third femoral shaft fracture. To our knowledge, there is no similar report in the English medical literature.
authors.affiliation: Department of Orthopaedics, Changhua Christian Hospital, 135 Nan Hsiao Street, Changhua, 500, Taiwan. 50560@cch.org.tw
authors.forename: Chia-Chieh
authors.initials: CC
authors.lastname: Wu
authors.forename: Chen-Tung
authors.initials: CT
authors.lastname: Yu
authors.forename: Chen-Pu
authors.initials: CP
authors.lastname: Hsieh
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Ing-Lin
authors.initials: IL
authors.lastname: Chang
mesh_terms: D000328:Adult; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography