Anterograde removal of broken femoral nails without opening the nonunion site: a new technique

• Autor(a) principal: Cabrita, Henrique Antônio Berwanger de Amorim
• Data de Publicação: 2010
• Outros Autores: Malavolta, Eduardo Angeli, Teixeira, Otávio Vilhena Reis, Montenegro, Nei Botter, Duarte, Fernando Aires, Mattar Jr., Rames
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Clinics
• Texto Completo: https://www.revistas.usp.br/clinics/article/view/18384
• topic: Femoral fractures; Fracture fixation; Intramedullary; Fracture healing; Complications; Orthopedics

OBJECTIVE: We describe a new technique for removing the distal fragments of broken intramedullary femoral nails without disturbing the nonunion site. METHODS: This technique involves the application of an AO distractor prior to the removal of the nail fragments, with subsequent removal of the proximal nail fragment in an anterograde fashion and removal of the distal fragment through a medial parapatellar approach. Impaction of the fracture site is then performed with a nail that is broader than the remaining fragmented material. RESULTS: Nails were removed from five patients using the technique described above without any complications. After a mean follow-up period of 61.8 months, none of these patients showed worsened knee osteoarthritis. CONCLUSION: The original technique described in this article allows surgeons to remove the distal fragment of fractured femoral intramedullary nails without opening the nonunion focus or using special surgical instruments.