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....

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Bibliographic Details
Published in:Indian journal of orthopaedics 2011-07, Vol.45 (4), p.347-350
Main Authors: Metikala, Sreenivasulu, Mohammed, Riazuddin
Format: Article
Language:English
Subjects:
Bone (long)
Canals
Care and treatment
Case reports
Conservative Orthopedics
Diagnosis
Femur
fluoroscopy
Fractures
Health aspects
imaging
Joints
Knee
Medicine & Public Health
Original
Original Article
Orthopedic surgery
Orthopedics
Surgery
Surgical Orthopedics
Trauma
Wire
Wounds
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Summary: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.
ISSN:0019-5413
1998-3727
DOI:10.4103/0019-5413.82342