THE HUCKSTEP NAIL - STABLE FIXATION OF MECHANICALLY DEFICIENT FEMORALBONE

A Huckstep intramedullary nail was used to treat 23 fractures in which the femur was mechanically deficient due to pathologic fracture, nonu nion, or complex fracture in osteoporotic bone, All nailings were perf ormed by open surgery, and in some cases this was augmented by cortico cancellous bone grafting, The Huckstep nail allows the use of multiple cross screws at 15-mm intervals, providing immediate and adequate sta bility with successful early postoperative weightbearing, The results at followup were good in functional and radiologic terms, with no case s of fixation failure or infection, The quality of instrumentation all owed the nail and screws to be inserted without difficulty; however, t he straight profile of the nail may cause problems in the distal femur , as seen in 1 patient, The authors conclude that this device offers s ignificant mechanical and practical advantages over most other forms o f fixation, where early weightbearing is desired in the presence of de ficient bone, It is not ideal for distal femoral fractures, particular ly in the presence of excessive femoral bowing.