A technique for extracting a buried Kuntscher nail from the femur during total hip arthroplasty

Abstract

We describe a novel technique that allows safe extraction of a buried Kuntscher nail during total hip arthroplasty in a patient with ipsilateral, symptomatic post-traumatic osteoarthritis of the hip. This method allows the surgeon to visualise the antegrade entry point of the nail allowing safe extraction of the device without compromising the result of the hip arthroplasty.

Episiotomy-assisted Incarcerated Femoral Nail Removal: Technical Note

“…Over the past 10 years, increasing numbers of total joint arthroplasties are being performed which has also been associated with higher rates of femoral nail removal [ 4 ]. Longitudinal episiotomy osteotomy [ 5 ], greater trochanter osteotomy [ 6 ], and formation of a femoral window [ 7 ] have been shown to be effective in loosening the nail for extraction. Common surgical instruments have also proven useful in nail removal including insertion of a Steinmann nail into bone [ 8 ] or the tip of a cannulated screw [ 9 ], use of an Ender’s nail [ 10 ], or use of a cancellous Schanz screw [ 11 ].…”

“…Unfortunately, there is limited evidence on how to proceed in this setting. Several published reports describe methods for removal of an incarcerated femoral nail in the setting of planned total hip arthroplasty [ 6 , 12 , 13 , 14 ]. In many of these cases, removal of the femoral head in preparation for total hip arthroplasty assists in removal of the nail due to increased exposure of the proximal segment of the nail.…”