BILATERAL FEMUR SHAFT FRACTURE IN POLIO PATIENT: CASE REPORT

Abstract

Poliomyelitis is a viral infection which affects anterior horn cells, resulting in isolated muscle
weakness and paralysis. Post-polio residual paralysis (PPRP) patients are commonly found in
orthopedic department. The femur is most commonly fractured bone in post-polio adults. Team
work by orthopedic surgeon, orthotist, and physiotherapist will give a satisfactory functional
outcome. We report a case of bilateral femur shaft fracture in polio patient and managed with
intramedullary nailing with good results.
Case report: 43 years old male patient, who is a post polio residual paralysis (PPRP) in right
lower limb, had bilateral femur shaft fractures following self fall at his home. In first stage, we
fixed the left femur shaft fracture fixed with intramedullary interlocking nail for non poliotic
limb. In second stage, we fixed the poliotic limb femur fracture with Titanium Elastic Nailing
System (TENS) after 5 days. We did open reduction and internal fixation of fractures with nails
due to deformed bone narrow medullary canal. Post operatively patient’s limb was protected
with high above knee slab with 30 degrees flexion. Follow up of patient was done at 6 weeks, 3
months and at 6 months. At 6 months follow up patient was walking with auxiliary crutches
without pain.
Conclusion: Intramedullary nailing for femur shaft fractures is a feasible, reliable, and less
invasive method in Post polio residual paralysis patients. Postoperative rehabilitation will be
demanding and it also influences the outcome.