Challenging Removal of Intramedullary Nails: Description of 2 Techniques With Proposal to Classify Nail Extraction Methods.

CASE: We present 2 techniques for removing intramedullary nails. In the first case, an intact, incarcerated short proximal femoral nail was removed without making an additional bone window and underwent hip arthroplasty in the same sitting. The other case had a small distal fragment of broken femoral nail removed through the nonunion site, and exchange nailing was performed. A classification system for various techniques is also proposed, which may help orthopedic surgeons best prepare in the event of failure to remove the nail using the standard technique.

CONCLUSION: Removal of an intramedullary nail can be challenging. In anticipation, all possible armamentarium should be kept ready.