PMC6070684_01
Patient presentation: A. X-ray image shows right neck of femur non displaced trans-cervical fracture with the presence of an Intra-medullary (Fassier-Duval telescoping rod) in the femur shaft. B. Computed tomography was obtained for pre-operative planning.
gr1.jpg
PMC6070684_01_gr1.jpg
fig0005
X-ray revealed right neck of femur non displaced trans-cervical fracture with an Intra-medullary rod (Fassier-Duval IM rod) in situ (Fig. 1A). Operative fixation was decided for the patient and computed tomography was obtained to evaluate for bone stock, screw insertion site, and direction (Fig. 1B).
A. Intra-operative image shows the fracture fixation with two 6.5 mm cancellous screws on either sides of the IM rod. B. Immediate post-op images confirm correct placement of the screws in both anteroposterior and lateral views.
gr2.jpg
PMC6070684_01_gr2.jpg
fig0010
However, we managed to place two cannulated screws (size 6.5 mm) in either ends of the rod, one anterior and another posterior to the rod, with no possibility of inserting a third screw due to the narrow neck (Fig. 2).
Five-month follow up showing complete union in anatomical position.
gr3.jpg
PMC6070684_01_gr3.jpg
fig0015
Five month follow up X-ray and computed tomography confirmed healing of the neck of femur fracture in anatomic position (Fig. 3).
Two and a half year follow up image shows no signs of avascular necrosis. Limb length discrepancy of left side being shorter can also be noticed.
gr4.jpg
PMC6070684_01_gr4.jpg
fig0020
Two and a half year following the surgical fixation, patient had satisfactory result of complete union with no signs of head vascular compromise (Fig. 4).