Cephalomedullary Case
Cephalomedullary Nailing of the hip has been showing good results and mechanical advantages in treating unstable intertrochanteric femur fractures (1). However, the use of these implants revealed some implants related complications in which many of them consider as technical issues (2). Our case report describes an early complication with the use of the short Zimmer natural cephalomedullary device for the treatment of an intertrochanteric fracture in which the lag screw missed the nail despite the content intraoperative fluoroscopic imaging that demonstrates proper screw orientation.
There are multiple known complications following the treatment with cephalomedullary implants (3). However, this particular complication has not been explored
in the literature before. Our theory is this kind of error is strongly linked to the flexibility of the carbon fiber guide of the Zimmer Natural system. Rotation of the carbon fiber guide to adjust the guide wire as per neck anteversion can result in wire missing the nail which is unnoticeable while using a rigid guide such in Titanium Fixation nailing system.
There are multiple known complications following the treatment with cephalomedullary implants (3). However, this particular complication has not been explored
in the literature before. Our theory is this kind of error is strongly linked to the flexibility of the carbon fiber guide of the Zimmer Natural system. Rotation of the carbon fiber guide to adjust the guide wire as per neck anteversion can result in wire missing the nail which is unnoticeable while using a rigid guide such in Titanium Fixation nailing system.