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Stabilisation of femoral non-union using
​Poller (Blocking) screws

-
​Advanced Technique for Antegrade Femoral Nail


X-rays below together with CT scan images suggest femoral shaft non-union. Despite self dynamisation it went the non-union. Apart from additional pain, self dynamisation did not add anything to the fracture union. Surprised?

femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces

How I use Poller (Blocking) screws in antegrade nailing of femur is described below. If you have any questions please email me.


X-rays after the fixation are below where no proper reaming was done and also nail was replaced by a thinner nail then the one removed. Quite the opposite from the standard teaching.

femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces

And after four months of walking ....
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces

After further 3 months, 7 months altogether I believe I understand it.
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces

1 year after the non-union surgery.
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces
femur, femoral non-union, femoral nail, broken screw, oblique fracture, sharing forces

​Discharged.

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  • Home
    • Knee Surgery >
      • Symptomatic Osteoarthritis of the Knee >
        • Primary Care >
          • Initial Management
          • Intermediate Care
          • Referral Treshold
        • Secondary Care >
          • Total Knee Replacement
          • High Tibial Osteotomy
          • Knee Arthroscopy
          • Complex Primary Total Knee Replacement
          • Postoperative Management
        • Procedures recommended by NICE
        • Procedures with limitations by NICE
        • Procedures not recommended by NICE
        • Viscosupplementation
      • Trauma to the Knee >
        • Meniscal Injuries
        • ACL Injury
      • Partial v Total Knee replacement
    • Limb Lengthening >
      • Femoral lengthening over the nail
  • Orthopaedic Trauma
    • Complex Trauma Impact
    • Principles of fine wire frame fixation >
      • Indications for fine wire frame
      • Complications >
        • Predictable complications
        • Unpredictable complications
      • Pin sites management
      • Activities >
        • Videos
        • Photos
    • Poller or Blocking screw >
      • Mechanic of Poller screw
      • Without and With a Poller Screw
      • Third Generation Poller Screws >
        • Epicentric poller screws in osteoporotic bone
        • Epicentric poller screws in comminuted spiral fracture
      • Use of Poller Screw(s) in Complex Cases >
        • Segmental Femoral Fracture
        • Low Supracondylar Femoral Fracture
        • Low Supracondylar Femoral Fracture 2nd case
        • Femoral Non-union - Antegrade Nail
        • Femoral Non-union - Retrograde nail
        • Distal Tibia Spiral Fracture
    • VAC irrigation
    • Complex Cases >
      • Femoral diaphysis defect
      • Capitellum Fractures
      • Distal Femoral Fractures
      • Proximal Humerus Fractures
      • Subtrochanteric Femoral Fractures
  • Osseointegration
    • Osseointegration-Physiotherapy
    • Osseointegration-Surgery
    • Osseointegration-NHS Perspective
  • Medico-legal
    • PI Solicitors
  • Blog
  • Contact
    • About
    • CV
  • Blog
  • New Page