{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T04:35:42Z","timestamp":1773376542730,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intramedullary nailing is the standard of care for femoral shaft fractures. Antegrade nails are designed for proximal insertion, while retrograde nails are for distal insertion, deviation from this pathway can result in mechanical failure. We report a 47-year-old female who presented with left thigh pain, swelling, and restricted mobility. Clinical examination revealed thigh deformity and ecchymosis, with preserved distal neurovascular status. Radiographs demonstrated an intramedullary nail with hypertrophic malunion at the distal femur with a proximal periprosthetic fracture. Computerized tomography imaging confirmed cortical breaches by screws, and an oblique fracture near the proximal screw. Images were suggestive of the use of an antegrade nail through a retrograde construct. The malpositioned nail was removed and replaced using the appropriate proximal entry site. Postoperative radiographs confirmed stable fixation. The patient reported improved mobility with radiographic healing. This case highlights the consequences of incorrect implant orientation and the importance of surgical verification.<\/jats:p>","DOI":"10.1093\/jscr\/rjag156","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:39:10Z","timestamp":1771591150000},"source":"Crossref","is-referenced-by-count":0,"title":["Retrograde improvisations and their iatrogenic complications: a case report of an antegrade femoral nail used as a retrograde construct"],"prefix":"10.1093","volume":"2026","author":[{"given":"Yaseen","family":"Ammar","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Jaber AlAhmad Hospital , PO Box 2270, Kuwait City ,","place":["Kuwait"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2958-438X","authenticated-orcid":false,"given":"Hussain","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Jaber AlAhmad Hospital , PO Box 2270, Kuwait City ,","place":["Kuwait"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan","family":"Dashti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Jaber AlAhmad Hospital , PO Box 2270, Kuwait City ,","place":["Kuwait"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salamah H","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Jaber AlAhmad Hospital , PO Box 2270, Kuwait City ,","place":["Kuwait"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"2026031216243714600_ref1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.5435\/00124635-200905000-00004","article-title":"Intramedullary nailing of femoral shaft fractures: current concepts","volume":"17","author":"Ricci","year":"2009","journal-title":"J Am Acad Orthop 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vara","volume":"17","author":"Patel","year":"2022","journal-title":"Radiol Case Rep"},{"key":"2026031216243714600_ref5","first-page":"46","article-title":"Retrograde nailing for treating femoral shaft fractures: a review","volume":"7","author":"DeCoster","year":"2018","journal-title":"Univ New Mexico Orthopaedics Res J"},{"key":"2026031216243714600_ref6","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1007\/s00402-013-1796-4","article-title":"Medial femoral condyle fracture as a complication of antegrade intramedullary nailing","volume":"133","author":"Neumayer","year":"2013","journal-title":"Arch Orthop Trauma Surg"},{"key":"2026031216243714600_ref7","first-page":"38","article-title":"Straight proximal femoral nails mismatch with the anterior bowing of the femur","volume":"7","author":"Fatih Yildiz","year":"2019","journal-title":"Bezmialem Sci"},{"key":"2026031216243714600_ref8","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1177\/230949900701500309","article-title":"Intramedullary nailing for pathological femoral fractures","volume":"15","author":"Sharma","year":"2007","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"2026031216243714600_ref9","doi-asserted-by":"publisher","first-page":"738","DOI":"10.5312\/wjo.v6.i9.738","article-title":"Subtrochanteric fractures after retrograde femoral nailing","volume":"6","author":"Mounasamy","year":"2015","journal-title":"World J Orthop"},{"key":"2026031216243714600_ref10","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1007\/s11999-008-0501-3","article-title":"Case report: Patella baja after retrograde femoral nail insertion","volume":"467","author":"Krieg","year":"2009","journal-title":"Clin Orthop Relat Res"},{"key":"2026031216243714600_ref11","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00402-015-2377-5","article-title":"Technical 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