A Novel Technique to Remove a Tibial Nail

We present a case where the proximal end of a cannulated tibial nail was inaccessible for removal.

Some common techniques for the removal of broken hardware are discussed in the literature, but there is no one technique that will work in every situation. Routine removal techniques may not suffice when removing a buried or broken tibial nail.

Difficulties were encountered removing a tibial nail which was deeply sunk into the proximal tibia from its entry point. Therefore, the fracture site was exposed, and the nail was cut. The proximal portion was removed in a retrograde fashion. Removing the distal end of the nail posed a dilemma after standard techniques failed, but it was successfully extracted by threading a Schanz pin into the exposed cannulated portion of the nail and then backslapping a T-handle.

This is a novel technique for the removal of an incarcerated segment of a cannulated tibial nail from the distal tibia when other techniques were unsuccessful.

The novel method presented in this case report allows for extraction of a sunken tibial intramedullary nail when extractor seating is difficult to obtain and the incarcerated distal segment of a cannulated tibial nail cannot be removed by standard techniques.

Mauras J, Krause P, Roubion R. A Novel Technique to Remove a Tibial Nail. Strategies Trauma Limb Reconstr 2024;19(3):169-170.