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Review
. 2021 Aug;55(4):362-366.
doi: 10.5152/j.aott.2021.20282.

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

Adel Ebrahimpour  1 , Farsad Biglari  1 , Mehrdad Sadighi  1 , Rodrigo Pesantez  2
Affiliations
Review

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

Adel Ebrahimpour et al. Acta Orthop Traumatol Turc. 2021 Aug.

Abstract

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

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Pre-operative radiography of left intertrochanteric fracture, which was compatible with type 31-A2-3 of AO/OTA classification.
Figure 2.
Figure 2.
Post-operative radiography of the first surgery.
Figure 3.
Figure 3.
Sixth-month control radiography revealed nail breakage just distal to the locking screw.
Figure 4.
Figure 4.
4. Inserting of 4mmk-wire, distal to the broken fragment under C-armcontrol.
Figure 5.
Figure 5.
Inserting of 4.5 mm Schanz pin in the central canal of the broken fragment.
Figure 6.
Figure 6.
Extracting the broken fragment proximally.
Figure 7.
Figure 7.
T-handle bar that was used for extracting the broken fragment of nail.
Figure 8.
Figure 8.
Early post-operative radiography of intertrochanteric fracture after removing the broken nail and re-fixation with another short PFNA.
See this image and copyright information in PMC

References

    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.
    1. 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. - PMC - PubMed
    1. 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
    1. 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. - PubMed
    1. 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. - PubMed

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