Removal of a broken distal cannulated intramedullary femoral nail with solid reamer with closed methods and without using C-arm: A case report

Abstract

Intramedullary nailing of long bone fractures is an accepted technique with the advantages of not disturbing the fracture hematoma and the biomechanical superiority over plating.1 However, problems with the nail are not infrequent, with broken nails and locking screws particularly posing a difficult problem for the orthopedic surgeon, especially when nail get broken due to cyclical stress of retrauma at site of distal screw placement as this the one of the weak part of intramedullary nail. Many techniques are described for extraction of the distal broken intramedullary nail that require special equipment like olive wires or laparoscopic grabbers.1–3 There are many difficulties at times This equipment may not be always readily available which can make the process quite difficult. In remote parts of developing nation availability of C-arm is also an issue. We describe a simple reproducible method of extraction of the distal broken cannulated femoral nail fragment by antegrade approach without using C-arm and opening fracture site by using solid K-nail reamer. We have successfully used this technique to extract nail which is broken at D1 SCREW site, by using sequential K-nail reamer of size smaller than nail diameter in a young adult male patient.