Abstract
Treatment of closed fractures of the tibial shaft by intramedullary nailing has become standard practice [1]. However, broken implants such as a plastic medullary tube [2] or a broken nail or broken screws can occur either intraor postoperatively. This is a report of a case of premature failure of the two distal screws of the IC Nail in a patient with fractured distal third of the tibia. Although bony healing was prompt after the application of compression, it was noted that one of the two distal screws was significantly bent. Compression was applied immediately after the operation by the method recommended by the developers of the IC Nail1. Serial follow up showed early breakage of the bent screw, and bending of the other remaining distal screw as well. The opportunity is taken to discuss the biomechanical basis of the early failure of the two distal screws, and the necessary precautions needed in the use of the IC Nail are highlighted.
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