title: Prophylactic stabilization of proximal femoral metastatic bone disease: reconstruction intramedullary nail fracture.
abstract: Pathological fracture is an unfortunate manifestation of metastatic bone disease and whenever possible, prophylactic stabilization is preferable to fixation of fracture. The Russell-Taylor reconstruction intramedullary nail (Smith & Nephew Richards, Inc., Memphis, Tennessee) provides a stable construct for the prophylactic management of impending pathological fracture. Implant failure with this system typically involves distal locking screws. Cases of proximal screw cut-out and pullout have been reported as has breakage of both proximal locking screws. We present a case of failure of the Russell-Taylor delta reconstruction nail implant, just distal to the point of insertion of the proximal locking screws.
authors.affiliation: Department of Orthopedics and Trauma, Mater Misericordiae Hospital, Dublin, Ireland.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Devitt
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shelly
authors.forename: Marcus
authors.initials: M
authors.lastname: Timlin
authors.forename: John
authors.initials: J
authors.lastname: O'Byrne
mesh_terms: D001858:Bone Nails / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000209:etiology* / Q000517:prevention & control*; D005266:Femoral Neoplasms / Q000150:complications* / Q000556:secondary* / Q000628:therapy; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D017211:Treatment Failure