Extraction of Broken Interlocking Tibial Nails: A Review of Surgical Techniques and Practical Management

Abstract

Breakage of tibial interlocking nails is a rare complication and is associated with tibial nonunion. The distal part of a broken tibial nail is difficult to extract and can be a real challenge. Preoperative planning is important, as the retrieval techniques of broken implants are not routine operations. There are various techniques and instruments described by different authors with none being uniformly successful. Therefore, surgeons should know as many methods as possible to choose the most suitable one. Minimally invasive retrieval techniques should be favored because of their reduced morbidity, while fenestration extraction methods should be used as the second intention. Cannulated intramedullary nails are more prone to benefitting from minimally invasive retrieval techniques than solid ones. This paper reviews and describes the present techniques used to extract the distal part of broken tibial nails, to serve as a quick guide for surgeons who need it.

Comparison of Clinical Effects of Intramedullary Nail Internal Fixation and Traditional Steel Plate Internal Fixation in the Treatment of Zhang-Hou Fracture

“…The traditional steel plate internal fixation requires open reduction [4][5][6][7] and periosteum peeling off [8], which destroys the blood flow of the broken end of the fracture and soft tissue, increases the risk of postoperative wound infection and delays the fracture healing time. The tibial intramedullary nail internal fixation didn't destroy the blood supply and soft tissue around the fracture [9,10], and the fixation was reliable [11], which reduced the occurrence of postoperative complications. And the intramedullary nail has better biomechanical advantages [12,13], which makes the functional recovery of the affected limb faster [14].…”