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Broken intramedullary nails.

J L Franklin1, R A Winquist, S K Benirschke

  • 1Swedish Medical Center, Seattle, Washington.

The Journal of Bone and Joint Surgery. American Volume
|December 1, 1988
PubMed
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This study details the extraction of sixty broken intramedullary nails in fifty-six patients over 25 years. A custom hook effectively removed distal fragments, highlighting a solution for intramedullary nail failure.

Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Trauma care

Background:

  • Intramedullary nails are crucial for fracture fixation.
  • Nail breakage can complicate patient recovery and treatment.
  • Understanding breakage patterns is vital for improving implant design and surgical techniques.

Purpose of the Study:

  • To analyze the causes and extraction methods for broken intramedullary nails.
  • To identify common sites of breakage in different types of intramedullary nails.
  • To evaluate the effectiveness of a custom-made hook for fragment extraction.

Main Methods:

  • Retrospective review of 56 patients with 60 broken intramedullary nails (1962-1987).
  • Analysis of patient charts and radiographs to determine fracture types and nail breakage locations.

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  • Utilization of a custom-made hook for the extraction of distal nail fragments.

    • Main Results:

    • Small-diameter nails frequently broke at fracture or non-union sites.
    • Interlocking nails commonly fractured at interlocking holes or welded junctions.
    • Breakages often occurred in patients with unstable fracture patterns.
    • The interval from insertion to breakage varied widely (1-120 months).

    Conclusions:

    • Broken intramedullary nails present a significant challenge in orthopedic practice.
    • Specific breakage patterns are associated with different nail types and fracture conditions.
    • A custom extraction hook provides a viable method for managing distal nail fragment retrieval.