{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:16:44Z","timestamp":1756383404854,"version":"3.44.0"},"reference-count":42,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,3]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Refracture accompanied by nail bending in healed or unhealed femoral fractures is a rare complication, and its removal is challenging intraoperatively. A man in his mid-20s presented to the emergency department with a deformed thigh with a puncture wound in a below-knee amputee limb following a road traffic accident, and radiographs revealed a diaphyseal segmental femur fracture with an intra-articular distal femur fracture with a bent femur nail in situ. Attempts to remove a bent femoral nail frequently fail non-invasively and may cause iatrogenic damage. Cutting the bent femur nail using a conventional jumbo cutter and a nail\u2013plate construct (exchange nailing and 14-hole distal femur locking plate with bone grafting) to fix the fracture can tackle this type of condition. He was followed up in the outpatient department and was able to mobilise with crutches with a good range of knee movement and a below-knee prosthesis in situ.<\/jats:p>","DOI":"10.1136\/bcr-2024-263938","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T03:44:13Z","timestamp":1743133453000},"page":"e263938","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Removal of bent intramedullary nail in diaphyseal segmental femoral fracture with intra-articular distal femoral fracture after below-knee amputation"],"prefix":"10.1136","volume":"18","author":[{"given":"Saurabh","family":"Gupta","sequence":"first","affiliation":[{"name":"Orthopedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6197-5330","authenticated-orcid":false,"given":"Aakarsh","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Orthopedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7629-6440","authenticated-orcid":false,"given":"Akhil Mathew","family":"Jacob","sequence":"additional","affiliation":[{"name":"Orthopedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhay","family":"Elhence","sequence":"additional","affiliation":[{"name":"Orthopedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"2025082804301639000_18.3.e263938.1","doi-asserted-by":"crossref","first-page":"25546","DOI":"10.52965\/001c.25546","article-title":"Intramedullary nail: the past, present and the future - a review exploring where the future may lead us","volume":"13","author":"Wong Wei Kang","year":"2021","journal-title":"Orthop Rev (Pavia)"},{"key":"2025082804301639000_18.3.e263938.2","first-page":"10","article-title":"From the down to modern era: the history of the nailing","volume":"3","author":"Meccariello","year":"2016","journal-title":"Can Open Orthop Traumatol J"},{"key":"2025082804301639000_18.3.e263938.3","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/0020-1383(92)90012-H","article-title":"Interlocking nailing for fractures of the femur and tibia","volume":"23","author":"Pintore","year":"1992","journal-title":"Injury"},{"key":"2025082804301639000_18.3.e263938.4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1055\/s-2005-919122","article-title":"Closed intramedullary nailing of femoral fractures. 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