Removal of a Bent Tibial Intramedullary Nail: A Case Report and a Review of the Literature

Gaubert L and Breda R

Department of Orthopedics and Trauma Surgery, HIA Sainte-Anne, France

^*Correspondance to: Renaud Breda 

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Abstract:

Intramedullary nailing is the gold standard for the management of tibia fractures. The possible removal of the material can be considered at a distance from the pose. The 18-month period is commonly used as the minimum date on which this extraction can be considered. The recurrence of trauma on a tibia with existing osteosynthesis equipment may induce rare but serious complications such as deformity or rupture. Sometimes, the importance of the deformity is at the origin of vascular complications, imposing an urgent surgery as this clinical case shows. A 25-year-old patient was involved in a high kinetic road accident. The lesion showed an open fracture on a centromedular nail of the right leg with an irreducible deformation at 45° lateral flexion at the 1/3 mid-1/3 lower junction. He presented a vascular lesion with a weak distal pulse. We opted for an anterolateral abord with corticotomy to remove the nail by anterograde extraction. Secondarily, we performed plate osteosynthesis in a conventional manner. The presence of osteosynthesis equipment can expose to complications in case of trauma as illustrated in this clinical case. It seems that a complication to this degree of severity is infrequent in the literature. Ablation of osteosynthesis equipment must be included in the therapeutic project, particularly in a population at high risk of trauma.

Keywords:

Centromedullary Nail; Removal; Complication

Cite the Article:

Gaubert L, Breda R. Removal of a Bent Tibial Intramedullary Nail: A Case Report and a Review of the Literature. Clin Case Rep Int. 2019; 3: 1097.