HomeAnswersOrthopedician and Traumatologyrheumatoid arthritisThe InterTan nail got displaced and is causing pain. Kindly help.

How to manage interTan nail displacement in arthritis?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At June 22, 2018
Reviewed AtApril 23, 2024

Patient's Query

Hello doctor,

My mother, aged 67, got her hip bone joint fractured. She got operated and an InterTan nail got implanted. But the nail part got displaced from the hip side and now touching the hip bone causing pain. She is weak, has low bone density, and suffers from other diseases as well (rheumatoid arthritis, glaucoma, hypothyroidism, hypertension, and asthma). What should be the next course of action? Does new bone formation will occur in case if plaster will be done or does she needs joint replacement? Will plaster worsen her situation? How safe will a joint replacement be at her age and what will be the implications in the future? Which one will be beneficial for her considering her overall health status? Please suggest the best way forward.

Hi,

Welcome to icliniq.com.

She requires implant removal and joint replacement. This is a relatively safe procedure. Plaster cannot be applied over this.

Patient's Query

Thank you doctor,

The hip joint replacement has been performed by the doctor here but we could see a fracture in X-ray report. We are clueless now what to be done next? Does she require bed rest now and to wait for the fracture to heal? Is that she can start with minor load bearing physiotherapy? Please advice the best possible next action for her. How to proceed with her treatment now? I am attaching her latest X-rays.

Hi,

Welcome back to icliniq.com.

Surgery of hip replacement was fine. So, do not worry about the fracture. Mobilization will depend upon the surgeons choice. It varies with different surgeons. So, I would advise you to do weight bearing as the surgeon advices as he knows best clinically the state of the fracture as he has seen it. X-rays do not always give the exact picture. If it was me, I would advise her partial weight bearing mobilization with a walker.

Patient's Query

Hello doctor,

Thank you a lot for answering my queries. Few more things I would like to understand here. Is there any possibility for the fracture to heal if we go for bed rest for a month or if we start with partial load bearing? Is that we should wait for a month and let bone to adjust with current implant and strengthening of bone by calcium-rich diet so that further complications can be avoided? What will happen to fracture if it will not heal, will that remain like that forever? Will it create any discomfort or pain to my mother in long run or any future complications at any level (nerves damage) due to this fracture?

Hi,

Welcome back to icliniq.com.

  1. Fracture healing does not matter much as the implant is giving stability as it is well fixed. So, partial weight bearing is fine.
  2. Calcium and Vitamin D should anyways be taken.
  3. As I said even if the fracture does not heal, the patient will walk normally.
  4. No complications of nerves or blood vessels by fracture.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sharoff Lokesh Mohan
Dr. Sharoff Lokesh Mohan

Orthopedician and Traumatology

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