Introduction: Incarceration of intramedullary nails can pose a significant challenge. There are many reported techniques of nail removal, but when these fail, it can be difficult to determine how to proceed. Here, it is shown that a proximal femoral episiotomy can be used with great effect.
Case Report: 64-year-old male developed hip arthritis. The patient had a solid antegrade femoral nail placed 22 years ago that required removal for a hip arthroplasty. A proximal femoral episiotomy-assisted approach was used with good results and patient outcome.
Conclusion: There are several well described techniques to assist with incarcerated nail removal that all trauma surgeons should be familiar with. Proximal femoral episiotomy is a useful technique, every surgeon should have in their arsenal.
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http://dx.doi.org/10.13107/jocr.2023.v13.i01.3520 | DOI Listing |
Cureus
December 2024
Department of Surgery, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Subtrochanteric fractures in older patients are typically due to low-energy falls. The standard of care is intramedullary nailing. The Smith & Nephew Trigen Intertan (Memphis, TN, US) is an intramedullary nail with a novel design that incorporates two integrated compression screws.
View Article and Find Full Text PDFTrauma Case Rep
December 2024
Department of Orthopaedic Surgery and Sports Medicine, Detroit Medical Center, Detroit, MI 48201, United States of America.
We present a case involving a 36-year-old male who experienced a nail gun injury to the posterolateral knee, leading to intraoperative nail removal. We observed bisection of the common peroneal nerve during the procedure with tethering, fortunately without any functional or sensory deficits.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
Postaxial polydactyly (PAP) in the form of rudimentary soft tissue masses is quite common. Management involves ligation or surgical excision. Rarely do literature discussions cover complex variants in which the extra finger is fully developed.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
Department of Orthopedics and Trauma, Universidade Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil.
Purpose: Although several techniques have been described for bent intramedullary nail removal, there is no universally accepted strategy. We hypothesized that a device based on the action principle of a three-point bend fixture could facilitate extraction of bent intramedullary nails; this paper describes its design and experimental testing.
Methods: Five large synthetic left femurs and five steel intramedullary nails were used.
OTA Int
March 2025
Department of Orthopedic Surgery, Detroit Medical Center, Detroit, MI.
Introduction: Intramedullary femoral nails (IMFNs) need to be removed for subsequent joint replacement, refracture, nonunion, or infection. The tools used to extract newer IMFNs may not be suited for removal of older implants, especially if broken. The purpose of this study was to describe a novel technique in femoral nail extraction when primary measures fail and a report on 6 cases where it was used.
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