Case: A 51-year-old nonambulatory woman with type III osteogenesis imperfecta sustained a diaphyseal femur fracture during a transfer, distal to a childhood-placed intramedullary pin. At the time of presentation, the fracture was a painful atrophic nonunion, preventing effective transfer. Retrograde nailing with a motorized magnetic lengthening nail, inserted with preset distraction, allowed gradual compression, solid union, and pain relief. Conclusion: This report describes the method of off-label lengthening nail modification used for gradual compression of a femoral nonunion site, achieving healing in pathologic bone.
Nahm et al. (2026) studied this question.