Traumatic periimplant fracture after nail arthrodesis of the knee in a limb reconstruction case.

Many principles of bone reconstruction were successfully applied in this unique case of a 1.92m (6 ft 3 in.) tall 15 year old boy with intercalary leg amputation. This patient suffered from a 26 cm (10.2 in.) bone loss of his left distal femur and severe soft tissue damage with an irreparable extensor mechanism after motor cycle accident. After periimplant fracture below the knee arthrodesis nail, definite treatment consisted of implant exchange to an 870 mm (34.3 in.) long custom made nail, which is to our knowledge the longest implanted arthrodesis nail in literature. Therefore the aim of the study was to present our treatment strategies and pitfalls after traumatic periimplant arthrodesis nail fracture in an unusual case of limb reconstruction.