title: False femoral neck fracture detected during shaft nailing: a Mach band effect.
abstract: Femoral neck fractures are associated with femoral shaft fractures in 1% to 9% of cases. Undisplaced neck fractures are susceptible to displacement during shaft nailing. We report the case of a 57-year-old male patient in whom we performed standard intramedullary nailing for a femoral shaft fracture. In doing so, we identified a vertical radiolucent line at the femoral neck, which was thought to be further displacement of a hidden silent fracture or an iatrogenic fracture that developed during nail insertion. Consequently, we decided to switch to reconstructive femoral nailing. Postoperative hip imaging failed to show the femoral neck fracture that we saw in the operating room. Here, we discuss the aforementioned case and review the literature concerning this artifact.
authors.affiliation: Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. kyang@yuhs.ac
authors.forename: Kyu Hyun
authors.initials: KH
authors.lastname: Yang
authors.forename: Sungjun
authors.initials: S
authors.lastname: Kim
authors.forename: Ji Do
authors.initials: JD
authors.lastname: Jeong
mesh_terms: D016477:Artifacts; D005264:Femoral Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography
keywords: Pseudofracture; femur neck; mach band; nailing
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