Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2022; 13(5): 528-537
Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.528
Intramedullary bone pedestal formation contributing to femoral shaft fracture nonunion: A case report and review of the literature
Charles B Pasque, Alexander J Pappas, Chad A Cole Jr
Charles B Pasque, Alexander J Pappas, Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, United States
Chad A Cole Jr, University of Colorado School of Medicine, Aurora, CO 80045, United States
Author contributions: Pasque CB contributed to the conceptualization, design, data collection, methodology, project administration, supervision, writing, and revising of the manuscript; Pappas AJ contributed to the initial data collection and writing of the manuscript; Cole Jr CA contributed to the data analysis, literature review, and revision of the manuscript; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Each of the authors declare no conflict of interest.
CARE Checklist (2016) statement: The CARE checklist (2016) statement has been correctly completed. The file was previously sent to the reviewer.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Charles B Pasque, MD, Professor, Program Director, Team Physician, Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma College of Medicine, 800 Stanton L. Young Blvd, AAT-3400, Oklahoma City, OK 73104, United States. charles-pasque@ouhsc.edu
Received: August 28, 2021
Peer-review started: August 28, 2021
First decision: November 17, 2021
Revised: November 28, 2021
Accepted: April 25, 2022
Article in press: April 25, 2022
Published online: May 18, 2022
Processing time: 257 Days and 8 Hours
Core Tip

Core Tip: Femoral shaft fracture nonunion after surgical fixation is a rare complication known to be associated with infection, anatomic abnormalities, hardware failure, and other aseptic etiologies. It is now known that intramedullary bone pedestal formation can also be a cause of nonunion after fracture dynamization. In order to prevent this complication, surgeons should elect to use a maximal length intramedullary nail during initial fixation and follow up closely if the patient is showing signs of delayed union.