{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:59:17Z","timestamp":1763463557333,"version":"3.45.0"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nThe expandable intramedullary nail is self-locking and has the advantage of reducing operating time and exposure to ionizing radiation. The nail is recommended for simple diaphyseal fractures involving the middle third of long bones, where the nail can bypass the fracture site by at least 5 cm. We encountered a unique complication with the expandable nail in a simple transverse shaft fracture at the junction of the middle and distal third of the left femur in an otherwise healthy 57-year-old man. The fracture was reduced and a 12-mm expandable nail was inserted. Following full expansion, intraoperative radiographs were obtained prior to closure. After six postoperative weeks, it was noted that the nail expanded the femoral canal, converting a simple fracture to a distally progressing comminuted fracture with a butterfly fragment. A review of the intraoperative radiographs showed slight widening of the medullary canal at the level of the fracture. As the alignment was satisfactory and callus was present, no further surgical intervention was considered. The patient was advised not to bear weight and was provided with a locked knee brace in extension to wear for six weeks. Radiographs at 12 weeks demonstrated good progress of healing with adequate callus and the patient was permitted to bear weight as tolerated and commence knee flexion. The fracture united satisfactorily at four months. This adverse experience emphasizes that caution should be exercised when expanding the nail, with close observation of the medullary canal diameter during the later stages of expansion.\n\n\u00d6zet\n\nGeni\u015fleyebilir intramed\u00fcller \u00e7ivi kendi kendine kilitlenir ve ameliyat s\u00fcresini ve iyonize radyasyona maruz kalmay\u0131 azaltmas\u0131 bak\u0131m\u0131ndan avantajl\u0131d\u0131r. \u00c7ivi uzun kemiklerin orta \u00fc\u00e7te birlik k\u0131sm\u0131nda olu\u015fan basit diyafiz k\u0131r\u0131klar\u0131 i\u00e7in \u00f6nerilmektedir; bu durumda k\u0131r\u0131k b\u00f6lgesinden en az 5 cm i\u00e7eri girebilir. Elli yedi ya\u015f\u0131nda, ba\u015fka bir sa\u011fl\u0131k sorunu olmayan bir erkekte, sol femurun orta ve distal \u00fc\u00e7te birlik k\u0131s\u0131mlar\u0131n\u0131n birle\u015fim yerinde olu\u015fan basit bir transvers cisim k\u0131r\u0131\u011f\u0131n\u0131n tedavisi i\u00e7in kulland\u0131\u011f\u0131m\u0131z geni\u015fleyebilir \u00e7ivinin yol a\u00e7t\u0131\u011f\u0131 nadir bir komplikasyonla kar\u015f\u0131la\u015ft\u0131k. K\u0131r\u0131\u011f\u0131n yerle\u015ftirilmesinden sonra 12 mm\u2019lik geni\u015fleyebilir \u00e7ivi uyguland\u0131. Geni\u015fleme tamamland\u0131ktan sonra, yara kapat\u0131lmadan \u00f6nce hastan\u0131n radyografik kontrol\u00fc yap\u0131ld\u0131. Ameliyat sonras\u0131 alt\u0131nc\u0131 haftada \u00e7ivinin femur kanal\u0131n\u0131 geni\u015fletti\u011fi fark edildi; \u00fcstelik, basit bir k\u0131r\u0131k, distal y\u00f6nde ilerleyen kelebek fragmanl\u0131 par\u00e7al\u0131 bir k\u0131r\u0131\u011fa d\u00f6n\u00fc\u015fm\u00fc\u015ft\u00fc. Ameliyat s\u0131ras\u0131ndaki radyografiler tekrar incelendi\u011finde, med\u00fcller kanal\u0131n k\u0131r\u0131k seviyesinde hafif\u00e7e geni\u015flemi\u015f oldu\u011fu g\u00f6r\u00fcld\u00fc. Kemik dizilimi tatmin edici oldu\u011fundan ve kallus olu\u015fumu g\u00f6zlendi\u011finden ek bir cerrahi giri\u015fim d\u00fc\u015f\u00fcn\u00fclmedi. Hastaya k\u0131r\u0131k baca\u011f\u0131na y\u00fck vermemesi s\u00f6ylendi ve alt\u0131 hafta s\u00fcresince ekstansiyonda kilitli diz breysi uyguland\u0131. On ikinci haftada \u00e7ekilen radyografide yeterli kallus olu\u015fumu ile iyi bir iyile\u015fme seyri g\u00f6zlendi ve hastan\u0131n tolere edebilece\u011fi derecede y\u00fck vermesine ve diz fleksiyonuna izin verildi. K\u0131r\u0131k d\u00f6rt ayda tatmin edici derecede kaynad\u0131. Bu olumsuz deneyim, \u00e7iviyi geni\u015fletirken dikkat edilmesi ve geni\u015fletmenin ilerleyen a\u015famalar\u0131nda med\u00fcller kanal \u00e7ap\u0131n\u0131n yak\u0131ndan takip edilmesi gerekti\u011fini g\u00f6stermi\u015ftir.<\/jats:p>","DOI":"10.3944\/aott.2010.2162","type":"journal-article","created":{"date-parts":[[2010,11,28]],"date-time":"2010-11-28T10:22:18Z","timestamp":1290939738000},"page":"166-168","source":"Crossref","is-referenced-by-count":1,"title":["Expanding nail or expanding femur An adverse event with the expandable intramedullary nail"],"prefix":"10.5152","volume":"44","author":[{"given":"Soham","family":"Gangopadhyay","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"D. Riley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chellappan","family":"K. Sivaji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,8]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2376\/2333","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:56:31Z","timestamp":1763463391000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,8]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,1,2]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2010.2162","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"type":"electronic","value":"2589-1294"},{"type":"print","value":"1017-995X"}],"subject":[],"published":{"date-parts":[[2020,2,8]]}}}