Title: Bent and Incarcerated Vnail in A Distal 1/3rd Tibia and Fibula Fracture: A Rare Case Report
Authors: Dr Abhijit Tayade, Dr Sachin Kale, Dr Sanjay Dhar, Dr Abhay Agarwal, Dr Naba Krishna Gohain
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.62
Intramedullary nailing is the gold standard technique for treatment of tibial shaft fractures. Bending of a nail secondary to high velocity trauma is a complication, encountered in healed or unhealed tibial shaft fractures. Removal of such a nail is always a challenge as the bent nail needs to be removed because it might take the shape of the nail; which is likely to become weaker and weaker as a result of the angulation and may break in future. Removal should be done as early as possible. We report this case of bent nail removal in a 47-year-old man, admitted in our hospital who sustained a fracture of the left distal 1/3rd tibia and fibula with V nail in situ due to a roadside accident. A 47yr old male patient presented to us with pain and deformity in left leg after an alleged history of road traffic accident. Patient was a post operated case of left distal 1/3 rd tibia and fibula fracture operated with closed reduction and internal fixation with v nail 10 years ago. patient had recovered completely post operative at that time and was given above knee cast for 3 months and then started weight bearing after 3 months as advised my his previous surgeon. 1. M. R. Brinker and D. P. O'Connor, “Exchange nailing of ununited fractures,” Journal of Bone and Joint Surgery A, vol. 89, no. 1, pp. 177–188, 2007. View at Publisher · View at Google Scholar · View at Scopus 2. D. J. Hak and M. McElvany, “Removal of broken hardware,” Journal of the American Academy of Orthopaedic Surgeons, vol. 16, no. 2, pp. 113–120, 2008. 3. S. M. Blake, “A technique for the removal of the distal part of a broken intramedullary nail,” Annals of the Royal College of Surgeons of England, vol. 91, no. 2, pp. 169–170, 2009. 4. K. Riansuwan, C. Carter, and O. Nercessian, “Removal of broken long gamma nail: a modified guide wires technique,” The Journal of Trauma, vol. 64, no. 2, pp. 517–519, 2008. 5. A. H. Karladani, “Removal of a broken nail using a guide wire and a screw,” Acta Orthopaedica, vol. 77, no. 6, pp. 986–988, 2006. 6. R. Lor Randall, R. J. Hall, and P. B. Slabaugh, “Closed removal of a segmental intramedullary rod: a technical report,” Journal of Orthopaedic Trauma, vol. 10, no. 5, pp. 363–365, 1996. 7. J. L. Franklin, R. A. Winquist, S. K. Benirschke, and S. T. Hansen Jr., “Broken intramedullary nails,”Journal of Bone and Joint Surgery A, vol. 70, no. 10, pp. 1463–1471, 1988. 8. N. T. Brewster, G. P. Ashcroft, and T. R. Scotland, “Extraction of broken intramedullary nails: an improvement in technique,” Injury, vol. 26, no. 4, p. 286, 1995. 9. Schmidt AH, Finkemeier CG, Tornetta P 3rd. Treatment of closed tibial fractures. Instr Course Lect 2003;52:607-22. 10. Sonanis SV, Lampard AL, Kamat N, et al. A simple technique to remove a bent femoral intramedullary nail and broken interlocking screw. J Trauma 2007;63(2):435-438. 11. Apivatthakakul T, Chiewchantanakit S. Percutaneous removal of a bent intramedullary nail. Injury 2001;32(9):725-726 12. Patterson RH, Ramser JR Jr. Technique for treatment of bent Russell-Taylor femoral nail. J Orthop Trauma 1991;5(4): 506-508Abstract
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