Mechanical failure of a femoral lengthening nail: a case report

BACKGROUND: This case report describes the mechanical failure of a femoral lengthening nail in order to allow early recognition and prevent its occurrence. CASE PRESENTATION: A femoral lengthening nail was used to achieve goal distraction length over eight weeks and sustained a mechanical failure during progressive weightbearing. Re-distraction was attempted with subsequent non-weight-bearing status. Although the patient was not able to attain the original goal length, radiographs demonstrated stable shortening of the patient’s right lower extremity along with early signs of incomplete regenerate bone. She eventually received exchange nailing with bone graft. CONCLUSION: Post-operative protocol and weight-bearing status should be further researched and standardized after re-evaluating the mechanical stiffness of the intramedullary nail construct.