Tips of the trade #10. Timesaving instruments for removing the distal interlock of a Brooker-Wills femoral intramedullary rod.

Removing the distal fixation wings (interlock) of a Brooker-Wills femoral intramedullary rod can be a time-consuming and difficult procedure. If the granulation tissue in the proximal aspect of the intramedullary rod is hypertrophic and scarred in, the screw-in extractor device used for removal of the distal fixation wings is sometimes difficult to engage. We always have two instruments available in the operating room to aid in the removal of the distal fixation wings: a large- or medium-sized arthroscopic alligator clamp grabber and head-lamp or flashlight. We believe that these significantly help reduce the time necessary to remove the granulation tissue and allow better visualization of the screw-in site on the distal fixation wing device for placement of extractor, thus ensuring a shorter procedure.