Technique for removal of intramedullary nails when there is failure of the proximal extraction device: a report of three cases.

When attempting to remove an intramedullary nail, the extraction device can fail. This can occur due to stripping of the proximal threads or, more rarely, due to entrapped broken metal devices (impacted cap screws; broken introducers, extractors, or taps). This latter situation is particularly problematic if access to the intramedullary portion of the nail and proximal threads is not possible. A technique for implant removal utilizing a high-speed drill is described in this report.