How to extract a broken cephalomedullary nail safely? A case presentation and review of the literature

Application rate of cephalomedullary nails in treatment of pertrochanteric fractures has been increased. Althoughcephalomedullary nail breakage is rare, the occurrence is catastrophic and removingdistal fragment of the broken nail isalways a challenging issue. Many techniques have been described for extracting broken nails, but most of them are used forconventional femoral nails. Furthermore, many of these techniques require specific extraction devices. Herein, we introducea simple technique to remove the distal fragment of broken cephalomedullary nail with the least equipment requirements.

___

1. Rollo G, Rinonapoli G, Pichierri P, Bisaccia M, Caraffa A, Meccariello L. Breakage in two points of a short and undersized “Affixus” cephalomedullary nail in a very active elderly female: A case report and review of the literature. Case Rep Orthop. 2018;2018:1-8. 10.1155/2018/9580190

2. Johnson NA, Uzoigwe C, Venkatesan M, et al. Risk factors for intramedullary nail breakage in proximal femoral fractures: A 10-year retrospective review. Ann R Coll Surg Engl. 2017;99(2):145-150. 10.1308/rcsann.2016.0297

3. Iwakura T, Niikura T, Lee SY, et al. Breakage of a third generation gamma nail: A case report and review of the literature. Case Rep Orthop. 2013;2013:1-5 10. 1155/2013/172352

4. Dorr LD, Faugere M-C, Mackel AM, Gruen TA, Bognar B, Malluche HH. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14(3):231-242. 10.1016/8756-3282(93)90146-2

5. Liu W, Zhou D, Liu F, Weaver MJ, Vrahas MS. Mechanical complications of intertrochanteric hip fractures treated with trochanteric femoral nails. J Trauma Acute Care Surg. 2013;75(2):304-310. 10.1097/TA. 0b013e31829a2c43

6. Parmar DS, Porecha MM, Chudasama SL. Long proximal femoral nails versus short proximal femoral nails for the management of proximal femoral fractures: A retrospective study of 124 patients. Eur J Orthop Surg Traumatol. 2011;21(3):159-164. 10.1007/s00590-010-0683-8

7. Li Z, Liu Y, Liang Y, Zhao C, Zhang Y. Short versus long intramedullary nails for the treatment of intertrochanteric hip fractures in patients older than 65 years. Int J Clin Exp Med. 2015;8(4):6299-6302.

8. Sohatee MA, Bennet J. A systematic review of short versus long intramedullary fixation in the management of pertrochanteric fractures. Trauma (United Kingdom). 2018;20(3):161-168. 10.1177/1460408617717538

9. Middleton RG, McNab ISH, Hashemi-Nejad A, Noordeen MHH. Multiple guide wire technique for removal of the short distal fragment of a fractured intramedullary nail. Injury. 1995;26(8):531-532. 10.1016/0020-1383(95)00103-G

10. Brewster NT, Ashcroft GP, Scotland TR. Extraction of broken improvement intramedullary in technique. Injury. 1995;26(4):286. 10.1016/0020-1383(95) 90020-X

11. Levy O, Amit Y, Velkes S, Horoszowski H. A simple method for removal of a fractured intramedullary nail. J Bone Joint Surg Br. 1994;76(3):502. 10.1302/ 0301-620X.76B3.8175869

12. Lovell J, Krishna D, Gehr E. Stuffing the nail: A simple technique for the extraction of a broken femoral nail. Trauma Case Reports. 2017;9:38-41.

13. Pongsamakthai W, Apivatthakakul T, Sangkomkamhang T. Removal of the broken femoral nail with T-reamer technique: A three-case report. J Clin Orthop Trauma. 2016;7:22-26.

14. Yadav SK, Agrawal AC. Humerus nail retrieval: A novel new technique. Techniques in Orthopaedics. 2021;36(2):190-192. 10.1097/BTO.0000000000000407

15. Man CH, Bae MW. Method for removing broken proximal femoral nails using existing screw hole. Acta Ortop Bras. 2018;26(1):72-74. 10.1590/1413- 785220182601148079
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

Comparison of systemic inflammatory responses of proximal femoral nail versus dynamic hip screw after treatment of patients with pertrochanteric fractures: A prospective comparative study

Kushtrim GREZDA, Mislav JELIC, Armond DACI, Cen BYTYQI, Qerim KIDA

How to extract a broken cephalomedullary nail safely? A case presentation and review of the literature

Adel EBRAHIMPOUR, Farsad BIGLARI, Mehrdad SADIGHI, Rodrigo PESANTEZ

Relationship between incidence of postoperative radial nerve palsy and surgical experience in the treatment of humeral shaft fractures through a posterior triceps splitting approach: A retrospective study

Woo-Yong LEE, Hyun-Dae SHIN, Kyung-Cheon KIM, Soo-Min CHA, Yoo-Sun JEON

The effect of a preoperative physical therapy education program on short-term outcomes of patients undergoing elective total hip arthroplasty: A controlled prospective clinical trial

Marina PINSKIY, Omri LUBOVSKY, Leonid KALICHMAN

Ultrasonographic measurement of the dimensions of proximal and distal patellar fragments after Niebauer-King Procedure for the management of congenital dislocation of the knee

Ömer Sunkar BİÇER, Mustafa TEKİN, Ömer Faruk EREN, Akif MİRİOĞLU, Mehmet Ali DEVECİ, Süreyya SOYUPAK

Comment on ‘’Spinopelvic alignment does not change after bilateral total hip arthroplasty in patients with bilateral Crowe type-IV developmental dysplasia of the hip‘’ by Can et al.

Alpaslan ÖZTÜRK, Nazan ÇEVİK, Yavuz AKALIN

Sliding rotational osteotomy for cases of dorsally angulated distal radius malunion: A technical note

Zaid AL-ANI, Khalid SHARIF, Amitabh J DWYER

Effect of different forearm positions on fragment rotation in extra-articular distal radius fractures: A cadaveric study

Maximilian LENZ, Maik NEUMANN, Christian K SPIES, Gregor STEIN, Peer EYSEL, Jens DARGEL, Johannes OPPERMANN

The second victim in orthopedics and traumatology

Anna CARRERAS-CASTANER, Carles MARTİN-FUMADO, C sar VARGAS-BLASCO, Josep ARIMANY-MANSO

Long-term clinical outcomes of innervated digital artery perforator flap in the treatment of fingertip injuries

Ali CAVİT, Osman CİVAN, Haluk ÖZCANLI