Modfied Technique for Intramedullary Femur Nail Removal

Background: The indication of implant removal of intramedullary nails is a subject of much discussion. The main concern is the increased morbidity of the preparation of the proximal nail end which can cause postoperative discomfort. The aim of the present study was to develop a soft-tissue protecting extraction technique and to evaluate it in comparison to the standard procedure. Material and Methods: With the modified technique the proximal end of the nail is preparated by a guidewire and the standard reamer used for implantation. This allows a soft-tissue protection with reduced morbidity, especially in patients with ossification. The outcome was assessed 4-20 weeks postoperatively and the operation times compared with those of 10 patients operated with the conventional technique. Results: From 5/09 to 12/10 we treated 9 patients with the mentioned technique. The operation time was reduced from a mean of 74.8 minutes to 32.0 minutes. Eight of nine patients had reduced or no discomfort postoperatively. Eight of nine patients stated that they had a benefit from the operation. Conclusion: The modified operation technique is capable of reducing operation time and morbidity in the implant removal of intramedullary nails.