Retrograde intramedullary nailing of the femur using a tibial nail--the adjunctive use of an existing implant: a case report.

A 74-year-old male involved in a pedestrian-automobile collision sustained a comminuted supracondylar-diaphyseal femur fracture. The fracture was stabilized by retrograde intramedullary fixation with a Synthes unreamed tibial nail. Knee motion reached 0 degree-120 degrees by the sixth postoperative day and the fracture healed within twelve weeks. Twelve months after his injury, his knee motion was symmetric to his uninjured side and he had resumed full preinjury activities, including martial arts training. Although antegrade intramedullary nailing remains the treatment of choice for fractures of the femur, this case highlights the usefulness of retrograde nailing and demonstrates the adjunctive application of an existing implant, the tibial nail, in certain special trauma situations.