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Updated: Apr 13, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
[A Problematic Case: Removal of a Broken Cannulated Tibial Nail]
R Langenhan1, N Reimers1, W Henke1
1Klinik für Orthopädie, Unfall- und Handchirurgie, Hegau-Bodensee-Klinikum Singen, Gesundheitsverbund Landkreis Konstanz gGmbH.
Abstract:
We present a case illustrating a simple and safe technique for the removal of a broken cannulated tibial nail after a pseudarthrosis of a lower leg shaft fracture. A 3 mm Ball-Tip guide wire was inserted into the proximal and the distal segment of the nail. A 2.5 mm tip-flattened second wire was forwarded into the distal segment pushing the Ball-Tip guide wire out of the axis and blocking it. This way the Ball-Tip could act as a hook and consecutively could be knocked back with an impactor forceps removing the complete nail. An exchange nailing was performed with a reamed AO standard nail and the further course was uneventful with a healed fracture after 12 months.
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