Retrograde tibial nail for femoral shaft fracture with severe degloving injury.

We report an unusual case involving a motorcycle-vehicle collision, in which a 21-year-old woman sustained severe bilateral lower extremity degloving injuries and an associated right femoral shaft fracture. The trauma team was consulted to treat this disastrous event. Due to extensive contamination of the open wound around the entry site, retrograde intramedullary nailing was chosen to fix the fractured femoral shaft in preference to antegrade intramedullary nailing. A tibial interlocking nail was used as a substitute for immediate bony stabilization to facilitate soft tissue debridement and subsequent reconstruction. The excellent range of motion achieved in the right knee joint, without infection, limb-length discrepancy, rotational instability or angular malalignment, was encouraging.