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Difficulty in removal of certain intramedullary nails
D Seligson1, P A Howard, R Martin
1Department of Orthopedics, University of Louisville, KY 40202, USA.
Clinical Orthopaedics and Related Research
|July 1, 1997
Summary
Removing intact intramedullary nails can be difficult due to implant design. This complication in femur and tibia fracture treatment highlights the need for improved nail engineering or absorbable alternatives.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Trauma management
Background:
- Intramedullary nailing is a standard surgical procedure for femur and tibia diaphyseal fractures.
- The technique, introduced in the 1940s, has been extensively studied for its efficacy and complications.
- Difficulty in nail removal is an uncommon but significant complication.
Observation:
- This study presents five cases of challenging intramedullary nail removal.
- Inspection revealed a specific cross-sectional nail design hindering extraction.
- The unslotted distal end of the nail was implicated in the extraction difficulty.
Findings:
- A specific nail design feature prevents the extraction of intact intramedullary nails.
- The cross-sectional geometry of the interlocking nails obstructs removal from the medullary cavity.
- This complication is linked to the design of the interlocking portion of the nail.
Implications:
- Current intramedullary nail designs may lead to preventable surgical complications.
- Modifications in nail design, particularly the cross-sectional geometry, are recommended.
- The development of absorbable intramedullary implants could offer a solution to removal issues.