Alternative method for removing an impacted AO intramedullary nail

An intramedullary femoral nail became impacted after approximately one third of it had been removed by standard AO technique in a 28-year-old man. Vise-grip pliers were used to twist the nail into a cigar-wrapper shape. While the standard nail removal should always be tried first, this method, although arduous and time-consuming, should be considered when faced with the possibility of having to split the femur or saw through the impacted nail.