Bent Nail, Broken Mechanics: Effective Surgical Management of Femoral Non-union in Post-Polio Residual Paralysis – A Case Report
Case Report | Journal of Clinical Orthopaedics | Vol 10 | Issue 2 | July-December 2025 | page: 133-138 | J S R G Saran, Varun Devdass, N Vivek, S P Hemanth, G Goutham, C Abhilash
DOI: https://doi.org/10.13107/jcorth.2025.v10.i02.804
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 05 Aug 2025, Review Date: 02 Sep 2025, Accepted Date: 21 Nov 2025 & Published Date: 10 Dec 2025
Author: J S R G Saran [1], Varun Devdass [1], N Vivek [1], S P Hemanth [1], G Goutham [2], C Abhilash [3]
[1] Department of Orthopaedics, M S Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India,
[2] Department of Orthopaedics, Sanjay Gandhi Institute of Orthopaedics and Trauma, Bengaluru, Karnataka, India,
[3] Department of Orthopaedics, Dr. NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India.
Address of Correspondence
Dr. J S R G Saran,
Department of Orthopaedics, M S Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru – 560094, Karnataka, India.
E-mail: jsaran868@gmail.com
Abstract
Background: Femoral shaft fractures in limbs affected by post-polio residual paralysis (PPRP) are prone to non-union and implant failure due to altered biomechanics, deformities and compromised bone quality.
Case Report: A 36-year-old male with PPRP presented with painful inability to bear weight following implant failure of a previously nailed femoral fracture. Radiographs showed hypertrophic non-union with a bent retrograde nail and screw back-out. Exchange nailing was performed using modified positioning to accommodate severe PPRP-related deformities.
Results: The distorted nail was successfully removed, deformity corrected gently, and a larger, longer nail implanted. At 1-year follow-up, radiographs confirmed complete union. The patient achieved pain-free full weight-bearing and functional knee motion with tailored rehabilitation.
Conclusion: Exchange nailing is an effective solution for hypertrophic non-union with implant failure, even in complex PPRP-affected limbs, when individualized surgical planning and rehabilitation are employed.
Keywords: Post-polio residual paralysis, Femoral non-union, Bent intra-medullary nail, Implant failure, Exchange nailing, Deformity correction.
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| How to Cite this Article: Saran JSRG, Devdass V, Vivek N, Hemanth SP, Goutham G, Abhilash C. Bent Nail, Broken Mechanics: Effective Surgical Management of Femoral Nonunion in Post-Polio Residual Paralysis – A Case Report. Journal of Clinical Orthopaedics. July-December 2025;10(2):133-138. |
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