Jain Siddharth, Nag Hira L, Kantiwal Prabodh, Hulmani Devanand
Orthopedics, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2020 Jan 6;12(1):e6576. doi: 10.7759/cureus.6576.
Küntscher intramedullary nail (K-nail) proximal migration in the femoral medullary canal is a common postoperative complication. But spontaneous distal migration of the K-nail across the knee joint and protrusion over the tibia till the tibial tuberosity is a complication that has very rarely been reported in the literature previously. This is the case report of a 41-year-old man who presented with a pus discharging sinus over the tibial tuberosity for the last one year. K-nail insertion was done six years ago. The underlying cause of the migration of the K-nail is subject to controversy and speculation. Infection and delayed union with shortening are some etiological possibilities. Wrong selection of K-nail size, loosely fitted nail, premature weight-bearing, and disuse osteoporosis may also be contributory factors.
Küntscher髓内钉（K钉）在股骨髓腔内近端移位是一种常见的术后并发症。但K钉自发穿过膝关节向远端移位并突出于胫骨直至胫骨结节，这是一种此前文献中极少报道的并发症。本文报告了一例41岁男性患者，其胫骨结节处有脓性窦道已持续一年。六年前进行了K钉植入术。K钉移位的根本原因存在争议和猜测。感染以及伴有短缩的延迟愈合是一些可能的病因。K钉尺寸选择错误、钉子安装松动、过早负重以及废用性骨质疏松也可能是促成因素。
