Aggerwal Sameer, Soni Ashwani, Saini Uttam-C, Gahlot Nitesh
Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Chin J Traumatol. 2011 Apr 1;14(2):107-10.
Intramedullary interlocking nailing is a gold standard for treatment of tibial shaft fractures. Bending of a nail secondary to trauma is a rare complication, which may be encountered in healed or unhealed tibial shaft fractures. Removal of such bent nail is always a challenge. We reported this case to discuss various techniques for removal of bent nails and to share our experience in removing a bent tibial intramedullary nail in a 30-year-old man, who was admitted in our department with re-fracture of the right tibial shaft due to a roadside accident two years after the initial surgical treatment. The intramedullary nail, bent by 30 degrees and visible on anterioposterior as well as on lateral radiographs, was firstly weakened by partially cutting the convex wall, then straightened by applying external force, and finally removed by using the standard nail removal method.
髓内交锁钉固定是治疗胫骨干骨折的金标准。创伤导致的髓内钉弯曲是一种罕见的并发症，在已愈合或未愈合的胫骨干骨折中都可能出现。取出这种弯曲的髓内钉一直是一项挑战。我们报告该病例，旨在探讨取出弯曲髓内钉的各种技术，并分享我们为一名30岁男性取出弯曲胫骨髓内钉的经验。该患者在初次手术治疗两年后因路边事故导致右胫骨干再次骨折而入住我科。在正位和侧位X线片上均可见髓内钉弯曲了30度，首先通过部分切除凸侧钉壁削弱髓内钉，然后施加外力将其拉直，最后采用标准的取钉方法将其取出。
