[Ortho] post-nailing fracture

[orthoforum на weborto.net]

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