2 months old ILN femur + circlage wiring done some where. Will fracture unite or need removal of static screw. Im thinking dat already nail is longer if i remove static screw nail may palpate at proximal. sugetions plz
Manish BudhiaDon’t take out proximal screw bc there is only one static screw proximally.so if u remove that screw ,rotation will be at fracture site and leads to nu.distal screws are broken so nail is already dynamized.wait for one more month
Prashant YadavRemoving prox screw ll worse the situation by making fracture rotationally unstable and distal screws are already broken so nail is already in auto-dynamisation state. Do exchange nailing with larger diameter nail
Nitish BhanBoth the screws have broken and there is no distal hold.. the nail is wobbling and there is no rotational control..better leave it ..if u r lucky it may unite.a better option is to redo nailing with an appropriate diametre nail.removing nail will not help..it will make it more unstable and u might have hypertrophic non union..
Kir PatAny minor intervention like dynamizing, will lead nail penetration and protrusion ,instability,malunio and nondunion uncertainity and delayed rehab and broken screw removal ,by any shortcuts ,same procedural incision in exchange nailing by shorter ,may be same dia will solve all future impending and will make you and pt feel secure about results
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