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The Journal of Bone and Joint Surgery 79:247-51 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Removal of a Broken Solid Femoral Nail: a Simple Push-out Technique. A Case Report*

CHRISTIAN KRETTEK, M.D.{dagger}, PETER SCHANDELMAIER, M.D.{dagger} and HARALD TSCHERNE, M.D.{dagger}, HANNOVER, GERMANY

Investigation performed at the Trauma Department, Hannover Medical School, Hannover


   Introduction
 
An intramedullary nail subjected to cyclical loading will fatigue if stresses on the nail exceed its endurance limit. The factors that influence failure of the nail are the stability of the fracture, a non-union or delayed union, and the rehabilitation program2,3,14,16. The methods to remove the distal fragment of a broken hollow nail rely on the passing of hooks or screws down the center of the nail1,8,10,15. For a solid nail, this technique is not possible. We describe a technique for the removal of the distal segment of a broken solid femoral nail.


   Case Report
 
A twenty-four-year-old man sustained a closed fracture of the left femur, just distal to the isthmus, in a high-velocity motor-vehicle accident. The fracture was classified as B3 according to the AO system11 and as C2 according to the system of Tscherne and Oestern (Fig. 1-A). Other injuries included cerebral contusions, fractures of the . . . [Full Text of this Article]


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