An unpredictable complication of femoral reaming: When the reamer gets stuck

Intramedullary nailing has become the gold standard in surgical treatment for long bones shaft fractures. Many intraoperative complications may occur. We report an unusual complication of trapped bone fragments between the reamer and the cortex during intramedullary nailing of a simple femur shaft fracture. All Attempts to withdraw the reamer were unsuccessful. The fragments had to be removed through an open incision. This complication was probably caused by a migrated chip of cortical bone fragment from the inner cortex which caused incarceration of the reamer. If a loose intramedullary fragment is noted during nailing, it must absolutely not be ignored.