J Korean Fract Soc.  2010 Oct;23(4):377-381. 10.12671/jkfs.2010.23.4.377.

Removal of a Broken Intramedullary Nail with a Narrow Hollow Using a Bulb-tipped Guide Wire and Kirschner Wire: A Case Report

• Lee M
• Yang KH

• KMID: 1461495
• DOI: http://doi.org/10.12671/jkfs.2010.23.4.377

Abstract

To report the unusual failure of proximal femoral nail antirotation (PFNA) at the level of lag screw hole and introduce a simple technique for removal of a broken intramedullary nail with a narrow hollow using a bulb-tipped guide wire and Kirschner wire.

Keyword

Intramedullary nail; Narrow hollow; Bulb-tipped guide wire; Kirschner wire

MeSH Terms

Nails

Figure

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  Fig. 1 (A) Preoperative radiograph shows subtrochanteric fracture of left femur: Hypertrophy of the lateral cortex and transverse fracture with medial beak were noticed. (B) Postoperative radiograph after the initial operation: inadequate reduction status with flexion deformity at the fracture site.

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  Fig. 2 Nonunion and hardware failure developed at seven months after the operation.

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  Fig. 3 Intraoperative radiographs from image intensifier; after removing of the proximal portion of broken nail, bulb-tipped guide wire was introduced (arrow).

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  Fig. 4 Intraoperative radiographs from image intensifier; after removing distal interlocking screws a 10 mm length no. 3 Kirschiner wire was introduced into the distal interlocking hole and further pushed with a no 3. Steinmann pin. An arrow indicates the tip of a bulb-tipped guide wire.

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  Fig. 5 Intraoperative radiographs from image intensifier; bulb-tipped guide wire was gently pulled out until the bulb abutted and locked with the K-wire at the distal interlocking hole, then exchange IM nailing was done.

Reference

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