Supracondylar nail failure: Two case reports

We describe two case reports of supracondylar nail failure in young patient s who had sustained high energy, closed, comminuted supracondylar femoral f ractures. These injuries had been successfully treated using retrograde int ramedullary nails which failed several months later because of excessive ac tivity on the part of the patient without the presence of full flexion at t he knee. The failed implants were removed and dynamic condylar screws were inserted with bone graft to the fracture site. This revision procedure prod uced solid bony union. We recommend that these patients should not fully we ight bear, or engage in strenuous physiotherapy after nailing, until the fr acture has consolidated and a functional range of knee motion has been obta ined. Failed implants should be managed by nail removal, bone grafting and insertion of a dynamic condylar screw.