Removal of broken solid femoral nail: a modified bent tip guide wire technique

A broken solid femoral nail can be challenging to remove. We describe a modified bent tip guide wire technique for extraction of a broken solid retrograde femoral nail from the proximal femur. The broken nail was removed successfully through the original retrograde entry point to allow for an exchange femoral nailing in a patient with a hypertrophic non-union. This novel technique avoids any additional exposure other than that required to remove and insert the nail.     

Removal of a broken guide wire entrapped in a fractured femoral neck

Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS).Breakage of a guide wire during operation is a very rare condition.We met such a dilemma in DHS ...     

Removal of broken long gamma nail: a modified guide wires technique

We report a simple alternative procedure, modified ball-tipped guide wires technique, to remove a broken long gamma nail at the level of lag screw hole which is detected during a removal procedure. The fragment retained in the medullary canal was successfully removed without complication.     

Flexible intramedullary nail removal using a broken screw removal set

The use of flexible titanium intramedullary nails for management of pediatric long bone fractures and some adult fractures has become common. Nail removal after union can be challenging and often requires a larger exposure than nail placement to allow the insertion of grasping devices, such as pliers. A percutaneous technique for the removal of flexible intramedullary nails using extraction bolts from a broken screw removal set is presented. The technique is especially useful when the end of the nail is not prominent and where a hollow reamer from the same set can expose the nail end for the extraction bolt to be used.     

Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire

Background:

Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments.

Materials and Methods:

Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound.

Results:

The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up.

Conclusion:

We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.     

Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

Retrieval of a broken guide wire transfix- ing the acetabulum or with intrapelvic migration is challeng- ing and frustrating for surgeons. We here present a case report on a method to remove a broken guide wire transfix- ing the acetabulum through the proximal hole of recon nail using a grasping forceps. This method is little invasive,easy, time-saving and without need for changing the inital fixation.     

Removal of a broken massive reamed tibia nail

Summary A problem has arisen when replacing the reamed tibia nail by the massive unreamed tibia nail. In case of nail fracture it is difficult to remove the distal fragment from the medullary cavity. It may also occur that the connecting screw between the insertion handle and the nail breaks off at the edge of the implant, which much complicates removal of the nail. The authors have developed a technique to remove the implant without having to saw a fissure in the marrow. A concave instrument is slid over the part of the nail left behind after which the two are connected by means of a K wire. This method has been successfully applied in 2 patients.      

Removal of a broken trigen intertan intertrochanteric antegrade nail

Implant breakage is a serious complication after cephalomedullary nailing for unstable intertrochanteric fracture. Failure usually occurs at the lag screw hole in the nail body. On the other hand, lag screw failure is extremely rare and occurs around the nail-lag screw junction. We experienced rare mechanical failure of the Intertan nail, which showed breakage at the lag screw hole and failure of the integrated compression screw underneath the main lag screw.     

Removal of a broken intramedullary nail with a narrow hollow

This report describes a technique for removal of a broken interlocking intramedullary nail with a small diameter and narrow hollow using a modified smooth guide wire.     

Removal of a broken locking screw from the intramedullary canal using a sliding knot

A locking screw lost in the intramedullary canal during extraction of an intramedullary nail is not an uncommon problem. This report describes a simple procedure using sliding wire knot and an Ender nail for removing a broken locking screw from the intramedullary canal. This method allows the easy removal of a broken locking screw from the intramedullary canal without a special instrument.     

Removal of a broken cannulated tibial nail: a simple intramedullary technique

We present a case illustrating the extraction of a distal segment of a broken cannulated tibial nail. Using minimal soft tissue dissection, a ball-tipped guidewire is inserted through the medial malleolus. It is then threaded through the distal aspect of the broken nail. The guide wire is advanced further proximally out the standard knee incision. When the ball tip engages the end of the broken nail, it can be removed easily.     

Removal of a broken distal closed section intramedullary nail: report of a case using a simple method

A simple method to remove a broken distal closed section intramedullary nail is presented. The surgical technique and a case report are described. This technique eliminates the need for an additional exposure, other than that required to insert the nail, or any specialized equipment.     

Removal of the broken tip of a hexagonal screwdriver from a nail end cap using a magnetic bar

The tip of the hexagonal screwdriver can be broken and retained in the recess of the end cap of an intramedullary nail. It can happen when the position of the patient's limb suddenly changes during the tightening procedure. Removal of the broken tip is necessary due to metal incompatibility and for the potential of a future procedure. A simple solution for this problem is presented, the use of a magnetic bar normally used for removal of orbital metallic foreign bodies.