[Ortho] post-nailing fracture

[Wojciech Glinkowski]

Dear all,

Interesting discussion, Thx.
Play with osteoporotic bone is always the challenge.
Images sent by Professor Kanlic look nice, very good job. Excellent
achorage in distal fragment. However, unicortical screwing or
bicortical makes a difference, also for locked screws. Proximal
fragment unicortical fixation may present stability not easlily
predictable. Certainly its    
stability for wheelchair should be sufficient. Full weight bearing can
not be mentioned for this case. If minimal bearing is allowed full
weight single step may happen in elderly.
Gamma nail exchange may probably fit the criteria of optimal and
minimal invasivness, indeed. Removal could be relatively fast due to
large intramedullary diameter seen on X-ray.
I do agree that distal locking of the nail in distal femur remains
critical. 

Best regards

Wojciech Glinkowski