J Knee Surg 2013; 26(S 01): S006-S010
DOI: 10.1055/s-0031-1275391
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intercondylar Fibrotic Lesion After Retrograde Intramedullary Nailing of a Femoral Shaft Fracture: A Case Report and Review of the Literature

Rya Boscariol
1   Department of Anesthesiology, University of Ottawa, Ottawa, Ontario, Canada
,
Jacques A. Brunet
2   Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
,
Geoffrey F. Dervin
2   Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
› Author Affiliations
Further Information

Publication History

30 May 2010

02 February 2011

Publication Date:
23 March 2011 (online)

Abstract

Retrograde intramedullary nailing is a largely successful technique for the treatment of femoral shaft fractures, although reports of knee pain after this procedure are not uncommon. Here we describe the case of a patient who developed a polyp-like fibrotic lesion of the intercondylar notch nearly 2 years after retrograde intramedullary nailing of a femoral shaft fracture as discovered by arthroscopic evaluation. This lesion caused pain and compromised our patient's function; however, both of these measures were subjectively improved after the debridement of the lesion. This case emphasizes the necessity of long-term follow-up and further investigation into the cause and significance of postoperative knee pain in hopes of continuing to improve patient outcomes.

 
  • References

  • 1 Handolin L, Pajarinen J, Lindahl J, Hirvensalo E. Retrograde intramedullary nailing in distal femoral fractures—results in a series of 46 consecutive operations. Injury 2004; 35: 517-522
  • 2 Herscovici Jr D, Whiteman KW. Retrograde nailing of the femur using an intercondylar approach. Clin Orthop Relat Res 1996; (332) 98-104
  • 3 Moed BR, Watson JT. Retrograde intramedullary nailing, without reaming, of fractures of the femoral shaft in multiply injured patients. J Bone Joint Surg Am 1995; 77: 1520-1527
  • 4 Ricci WM, Bellabarba C, Evanoff B, Herscovici D, DiPasquale T, Sanders R. Retrograde versus antegrade nailing of femoral shaft fractures. J Orthop Trauma 2001; 15: 161-169
  • 5 Ostrum RF, Agarwal A, Lakatos R, Poka A. Prospective comparison of retrograde and antegrade femoral intramedullary nailing. J Orthop Trauma 2000; 14: 496-501
  • 6 Gregory P, DiCicco J, Karpik K, DiPasquale T, Herscovici D, Sanders R. Ipsilateral fractures of the femur and tibia: Treatment with retrograde femoral nailing and unreamed tibial nailing. J Orthop Trauma 1996; 10: 309-316
  • 7 Patterson BM, Routt Jr ML, Benirschke SK, Hansen Jr ST. Retrograde nailing of femoral shaft fractures. J Trauma 1995; 38: 38-43
  • 8 El Moumni M, Schraven P, ten Duis HJ, Wendt K. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures. Acta Orthop Belg 2010; 76: 219-225
  • 9 Iannacone WM, Bennett FS, DeLong Jr WG, Born CT, Dalsey RM. Initial experience with the treatment of supracondylar femoral fractures using the supracondylar intramedullary nail: a preliminary report. J Orthop Trauma 1994; 8: 322-327
  • 10 Leggon RE, Feldmann DD. Retrograde femoral nailing: A focus on the knee. Am J Knee Surg 2001; 14: 109-118
  • 11 Papadokostakis G, Papakostidis C, Dimitriou R, Giannoudis PV. The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: A systematic review of the literature. Injury 2005; 36: 813-822
  • 12 Lucas SE, Seligson D, Henry SL. Intramedullary supracondylar nailing of femoral fractures. A preliminary report of the GSH supracondylar nail. Clin Orthop Relat Res 1993; (296) 200-206
  • 13 Tornetta III P, Tiburzi D. Antegrade or retrograde reamed femoral nailing. A prospective, randomised trial. J Bone Joint Surg Br 2000; 82: 652-654
  • 14 Johnson EE, Marroquin CE, Kossovsky N. Synovial metallosis resulting from intraarticular intramedullary nailing of a distal femoral nonunion. J Orthop Trauma 1993; 7: 320-324 ; discussion 325–326
  • 15 Mechrefe AP, Bluman EM, Hulstyn MJ, Fadale PD. Preservation of knee articular surface with retrograde intramedullary nailing of the femur. J Knee Surg 2004; 17: 64-67