How to remove a bent intramedullary nail inexpensively: a technical trick

Joshua Odendaal


Background: A bent femoral intramedullary nail is a rare complication following secondary trauma to an unhealed femoral fracture site. Existing strategies for removal require the use of specialized instrumentation such as a diamond tipped drill or a high speed burr. Specialized orthopedic instrumentation is often expensive and frequently unobtainable in the developing world.Objectives: To provide a solution in resource poor settings and describe a unique approach to managing such complex cases.Methods: Novel, low cost, and successful use of industrial instruments for removing a femoral nail bent in situ in a 43 year old man who would have likely required a much more extensive operation without it.Results: Instrumentation was obtained from a local market and at a fraction of the cost of specific orthopedic instruments. This case presents a technical tip for managing this complication in the developing world.Conclusions: In a resource poor setting, we can recommend the judicious use of inexpensive industrial materials and instruments to manage complex cases.
Keywords: Bent, developing, femoral nail, fracture, resource-poor setting

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