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A Novel Technique to Remove a Tibial Nail
Jeffrey Mauras1, Peter Krause2, Ryan Roubion2
1Department of Orthopaedics, Louisiana State University Health Sciences Center-School of Medicine, New Orleans, Louisiana, United States of America.
Strategies in Trauma and Limb Reconstruction
|April 14, 2025
Summary
A novel technique successfully removed a deeply impacted tibial nail when standard methods failed. This innovative approach extracted an incarcerated segment using a Schanz pin and T-handle for difficult tibial nail removal.
Area of Science:
- Orthopedic surgery
- Traumatology
- Surgical techniques
Background:
- Tibial nail removal can be challenging, especially with broken or deeply embedded hardware.
- Standard removal techniques may be insufficient for complex cases of tibial nail impaction.
Observation:
- A case presented with a cannulated tibial nail where the proximal end was inaccessible for removal.
- Difficulties were encountered in removing a tibial nail deeply sunk into the proximal tibia.
Findings:
- The proximal portion of the nail was removed retrograde after exposing and cutting the fracture site.
- A novel technique involving a Schanz pin and T-handle was successfully employed to extract the distal nail segment when standard methods failed.
Implications:
- This case report introduces a new method for extracting deeply incarcerated tibial nails.
- The described technique offers a viable solution for challenging tibial nail removals where conventional extractors cannot be seated.
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