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Removal of a broken cannulated femoral nail: a novel retrograde impaction technique.

Riansuwan K, Tantigate D, Mahaisavariya B - Case Rep Orthop (2013)

Bottom Line: This report presents a surgical technique to remove a broken cannulated nail from the femur.A Harrington rod was modified for retrograde impaction of the retained fragment.This particular procedure was safe, simple, and promising.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Rehabilitation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

ABSTRACT
This report presents a surgical technique to remove a broken cannulated nail from the femur. A Harrington rod was modified for retrograde impaction of the retained fragment. The broken implant was finally removed without complication. This particular procedure was safe, simple, and promising.

No MeSH data available.


Related in: MedlinePlus

The picture shows patient positioning on a fracture operating table with a skeletal traction applied at the proximal tibia.
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fig2: The picture shows patient positioning on a fracture operating table with a skeletal traction applied at the proximal tibia.

Mentions: The patient was placed supine on a fracture operating table with pulling the affected leg on a skeletal traction at the proximal tibia (Figure 2). The proximal part of the nail was removed routinely by using the specific removal equipment. In order to protect the surrounding soft tissue regarding biology of fracture healing, the distal part of the broken nail was determined to be removed by closed technique. The fracture was reduced using the F-shaped reduction clamp (Figure 3(a)). A nail-driving guide wire was inserted into the medullary canal of the femur and passed across the fracture site into the lumen of the distal portion of the broken nail in order to keep fracture alignment and tract of nail removal (Figure 3(b)). Intercondylar notch of the femur was then perforated by an Awl reamer through a small incision and medial parapatellar approach. After enlarging the entry point with a 6 mm T-reamer, a contoured Harington rod (6 × 400 mm) was inserted through the entry point at the femoral condyle until the round tip of the rod engaged into the nail's lumen (Figure 4). Multiple impactions could then be applied on a wisegrip or T-chuck handle gripping the Harrington rod firmly. The nail was impacted upward along the tract controlled by the guide wire and eventually removed directly from the wound (Figures 5(a) and 5(b)).


Removal of a broken cannulated femoral nail: a novel retrograde impaction technique.

Riansuwan K, Tantigate D, Mahaisavariya B - Case Rep Orthop (2013)

The picture shows patient positioning on a fracture operating table with a skeletal traction applied at the proximal tibia.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852813&req=5

fig2: The picture shows patient positioning on a fracture operating table with a skeletal traction applied at the proximal tibia.
Mentions: The patient was placed supine on a fracture operating table with pulling the affected leg on a skeletal traction at the proximal tibia (Figure 2). The proximal part of the nail was removed routinely by using the specific removal equipment. In order to protect the surrounding soft tissue regarding biology of fracture healing, the distal part of the broken nail was determined to be removed by closed technique. The fracture was reduced using the F-shaped reduction clamp (Figure 3(a)). A nail-driving guide wire was inserted into the medullary canal of the femur and passed across the fracture site into the lumen of the distal portion of the broken nail in order to keep fracture alignment and tract of nail removal (Figure 3(b)). Intercondylar notch of the femur was then perforated by an Awl reamer through a small incision and medial parapatellar approach. After enlarging the entry point with a 6 mm T-reamer, a contoured Harington rod (6 × 400 mm) was inserted through the entry point at the femoral condyle until the round tip of the rod engaged into the nail's lumen (Figure 4). Multiple impactions could then be applied on a wisegrip or T-chuck handle gripping the Harrington rod firmly. The nail was impacted upward along the tract controlled by the guide wire and eventually removed directly from the wound (Figures 5(a) and 5(b)).

Bottom Line: This report presents a surgical technique to remove a broken cannulated nail from the femur.A Harrington rod was modified for retrograde impaction of the retained fragment.This particular procedure was safe, simple, and promising.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Rehabilitation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

ABSTRACT
This report presents a surgical technique to remove a broken cannulated nail from the femur. A Harrington rod was modified for retrograde impaction of the retained fragment. The broken implant was finally removed without complication. This particular procedure was safe, simple, and promising.

No MeSH data available.


Related in: MedlinePlus