Synovial metallosis resulting from intraarticular intramedullary nailing of a distal femoral nonunion.

An 80-year-old man sustained a T-shaped supracondylar fracture of the femur associated with distal one-third shaft comminution. Initial failure of a 95 degrees angle blade plate was followed by insertion of an intraarticular intramedullary nail stabilized with static locking-screw fixation. A second failure of the implant was treated by extraarticular tension band condylar buttress plate osteosynthesis. Severe knee synovial metallosis was found at the time of removal of the intraarticular nail device.