Displaced tibial intramedullary nail post fall and distal locking screw fracture

Case contributed by Dr Craig Hacking


Fall in rehab

Patient Data

Age: 40-45 years
Gender: Male

Comminuted fracture of the distal tibial shaft fixated with proximally and distally locked intramedullary nail. The most distal screw is fractured and the intramedullary nail is displaced anteriorly within the medullary cavity, resulting in mild shortening with increased anterolateral angulation of the distal tibial fracture fragment.

There is also shortening and increased anterolateral angulation of the comminuted distal fibular shaft fracture fragment.

No new fracture is identified. Unchanged alignment of the ankle joint.


Pre fall post internal fixation radiography

Intramedullary nail fixation of the comminuted distal tibial shaft fracture. Alignment is anatomic. No evidence of orthopaedic hardware failure.

Comminuted fracture of the distal fibular shaft remains mildly displaced.

Case Discussion

Nice example of traumatic failure of the distal locking screw

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Case information

rID: 39074
Case created: 19th Aug 2015
Last edited: 18th Aug 2017
Inclusion in quiz mode: Included

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