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History of femur fracture. Inserted IM rod with screws. Why is the proximal screw still in?

Hi, I m new to the forum.....I am a 58 year old male. I was in a serious MVA (hit by a drunk driver)in 99 that necessitated ortho surgery on all 4 limbs . Due to a fracture in my LT femur , an IM rod with 2 screws was inserted. In addition, my fractured LT hip was supported by a pin. In 2001, dueprimarily to a nonfunctional knee, a Dr. agreed to remove the IM and do a total knee replacement . When I awoke from the surgery he told me he was unable to remove the rod. He told me he spent a half hour trying. He did shorten the rod (I have the piece) by about 3 and removed the distal screw (have that too). He completed the replacement by wiring the prothesis to the bottom of the rod. I had some issues following the surgery - an infection in the scar and laster a manipulation in an attempt to gain more flexion . Overall my flexion and function improved but pain become more of an issue. In 2008, the same Dr. commented that the replacement was failing but at that time I was in need of a hip replacement and the other knee replacment - both of which were causing greater pain then the left. The RT hip came first and was done by another DR. This past December I went to see my Dr. (who did my hip and RT knee replacements) about the level 8-9 pain in my LT knee. He agreed that the knee needs a revision, but first, a trauma surgeon needs to remove the pin from my hip and the proximal screw. As evidence by the x-rays, the proximal screw is bent and slightly twisted on both sides of the femur. Only after recovery would he attempt the IM nail extraction and revision. I look at the dvd of my latest x-rays and am looking for answers. My question(s).....why is the proximal screw still in? What caused it to bend? Could the IM nail be removed without its removal? What are your thoughts about wiring the prosthesis to the remaining rod? Since that fateful day in 1999, I ve endured 15 procedures directly related to the incident. The thought of two more makes me sick. Any advice? Tom
Asked On : Sat, 2 Feb 2013
Answers:  1 Views:  211
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Orthopaedic Surgeon 's  Response
Thanks for writing to us.
The nail can bend due to the weight bearing in a partially healed bone. Sometimes when the nail becomes bent, it becomes difficult to remove due to the fibrosis around the nail. Since it is a bent nail, it is best to get it removed.
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Dr. Praveen Tayal
Answered: Thu, 7 Feb 2013
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