Decreased Femoral Fracture Load After Cephalomedullary Nail Removal

Description

In this episode of AI Talks with Bone & Joint, Brian and Lisa discuss a study published in May 2025 by GM Schwarz and colleagues, focusing on the biomechanical consequences of removing cephalomedullary nails, primarily used for fixing femoral fractures. The study finds that post-removal, the femurs show a significantly lower failure load—1,835 newtons compared to 4,523 newtons in controls—indicating a higher risk of fractures, particularly subcapital types. The research involved biomechanical testing of 20 specimens, revealing altered stress distribution and lower volumetric bone mineral density in femurs post-nail removal. The authors recommend caution with elective nail removals given the complications that may arise, including potential need for hip arthroplasty, and advise a cautious postoperative protocol. This comprehensive exploration underscores the importance of careful patient management following such surgeries to enhance outcomes.

Specialties

Paper Links

https://boneandjoint.org.uk/Article/10.1302/2046-3758.145.BJR-2024-0278.R2