title: Delayed femoral shaft fracture secondary to nail gun injury: a case report.
abstract: Nail gun injuries are common workplace occurrences among construction workers; however, delayed fractures of the femur after a nail gun injury are not found in the medical literature. We report the case of a patient who presented with such a fracture 3 days after accidentally firing a nail into his thigh. The patient was taken to the operating room for intramedullary nailing, irrigation and debridement, and antibiotic beads. Standard postoperative hospital care was provided, and after 2 days of intravenous antibiotics, the patient was returned to the operating room for removal of the antibiotic beads and a delayed primary closure. At the most recent follow-up, over 1 year postinjury, he had radiographic healing and was asymptomatic. Although it is difficult to predict whether the stress riser created by a nail gun injury will lead to a fracture, weight-bearing status and the aggressiveness of treatment to prevent infection are factors that need to be carefully considered in patients with this type of injury.
authors.affiliation: Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, CA 92134, USA. ebharris@nmcsd.med.navy.mil
authors.forename: Eric B
authors.initials: EB
authors.lastname: Harris
authors.forename: Kermit
authors.initials: K
authors.lastname: Booher
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Flotten
mesh_terms: D005264:Femoral Fractures / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D005389:Firearms; D006801:Humans; D008297:Male; D008875:Middle Aged; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*