Bent intramedullary femoral nail: a rare injury following high-energy trauma

Abstract

High-energy trauma may result in catastrophic orthopedic injuries, particularly in patients with existing long bone implants. Peri-implant fractures pose unique mechanical and biological challenges, especially when implant integrity is compromised. We report a rare case of a young adult with a previously healed femoral shaft fracture treated with an antegrade intramedullary nail. Following a motor vehicle accident, the implant experienced severe axial deformation, with associated new fractures at the midshaft and distal femur. Despite undergoing emergency interventions, the patient succumbed due to multisystem trauma. This case illustrates a rare mechanical failure where the intramedullary nail’s structural limits were exceeded. Radiological and biomechanical analysis provides insights into the forces involved and the potential need for implant redesign in high-risk trauma settings.