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. 2010 Mar;65(3):279-83.
doi: 10.1590/S1807-59322010000300007.

Anterograde removal of broken femoral nails without opening the nonunion site: a new technique

Henrique Antônio Berwanger de Amorim Cabrita  1 , Eduardo Angeli Malavolta, Otávio Vilhena Reis Teixeira, Nei Botter Montenegro, Fernando Aires Duarte, Rames Mattar Jr
Affiliations

Anterograde removal of broken femoral nails without opening the nonunion site: a new technique

Henrique Antônio Berwanger de Amorim Cabrita et al. Clinics (Sao Paulo). 2010 Mar.

Abstract

Objective: We describe a new technique for removing the distal fragments of broken intramedullary femoral nails without disturbing the nonunion site.

Methods: This technique involves the application of an AO distractor prior to the removal of the nail fragments, with subsequent removal of the proximal nail fragment in an anterograde fashion and removal of the distal fragment through a medial parapatellar approach. Impaction of the fracture site is then performed with a nail that is broader than the remaining fragmented material.

Results: Nails were removed from five patients using the technique described above without any complications. After a mean follow-up period of 61.8 months, none of these patients showed worsened knee osteoarthritis.

Conclusion: The original technique described in this article allows surgeons to remove the distal fragment of fractured femoral intramedullary nails without opening the nonunion focus or using special surgical instruments.

Keywords: Complications; Femoral fractures; Fracture fixation; Fracture healing; Intramedullary; Orthopedics.

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Figures

Figure 1
Figure 1
Intramedullary nail with a diameter that was 2 mm larger than the fractured nail propelling the distal fragment (fluoroscopic view)
Figure 2
Figure 2
Distal fragment of the nail being removed through the medial parapatellar incision
Figure 3 and 4
Figure 3 and 4
A fractured femoral nail in an unhealed femoral fracture (Anterior-Posterior and lateral radiographs)
Figure 5 and 6
Figure 5 and 6
Bone consolidation after replacement of the nail via the technique described in this manuscript (Anterior-Posterior and lateral radiographs)
See this image and copyright information in PMC

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