2021, Number 1
<< Back Next >>
Acta Ortop Mex 2021; 35 (1)
Complex extraction of Küntscher nails. Trephines and other surgical strategies
López-Orosa C, García-Lázaro F, Ladero-Morales F
Language: Spanish
References: 10
Page: 75-79
PDF size: 212.95 Kb.
ABSTRACT
Introduction: Removing an intact or broken intramedullary nail can be a real surgical challenge. In clinical cases many methods have been described, and there are many tools to allow their extraction. In this article, the experience in one of them is presented: the use of trephines.
Clinical cases: Three cases of Küntscher intramedullary nails are described, in which it was used, also listing in detail the steps to be followed in a nail extraction, arranging the techniques and assorted tools required to take the nail out, enable the surgeon to make a better extraction plan and prepare in advance any of the necessary resources in the case of failure during the surgery.
Conclusion: The use of trephines as an extraction system is an infrequent technique. It can be an alternative when the usual methods fail. It does not require new approaches, does not require the integrity of the proximal end of the nail, and can be used in most designs.
REFERENCES
Kose O, Guler F, Kilicaslan OF, May H, Yuksel HY. Removal of a bent intramedullary nail in lower extremity: report of two cases and review of removal techniques. Arch Orthop Trauma Surg. 2016; 136 (2): 195-202.
Liodakis E, Krettek C, Kenawey M, Hankemeier S. A new technique for removal of an incarcerated expandable femoral nail. Clin Orthop Relat Res. 2010; 468 (5): 1405-9.
Abdelgawad AA, Kanlic E. Removal of a broken cannulated intramedullary nail: review of the literature and a case report of a new technique. Case Rep Orthop. 2013; 2013: 461703.
Kumar V, Singh G, Kansal R, Aggarwal S. Kuntscher's nail removal techniques: an illustrative walkthrough its journey. Eur J Orthop Surg Traumatol. 2019; 29 (7): 1377-81.
Depuy-Synthes. Hip extraction instrumentation. DePuy Synthes Johnson & Johnson. 2014.
Krettek C, Mommsen P. Implant removal after intramedullary osteosyntheses. Literature review, technical details, and tips and tricks. Unfallchirurg. 2012; 115 (4): 299-314.
Tadros AM, Elhelw AM, Eldehi M, Al-Shaeel RA. Removal of a femoral intramedullary nail with impacted nail end cap using a broken screw extraction set: a case report and literature review. Acta Orthop Traumatol Turc. 2015; 49 (2): 217-9.
Goosen JH, Van Hellemondt GG. Primary total hip arthroplasty with a retained intramedullary femoral nail. Acta Orthop Belg. 2013; 79 (1): 114-6.
Mont MA, McGrath MS, Ulrich SD, Seyler TM, Marker DR, Delanois RE. Metal-on-metal total hip resurfacing arthroplasty in the presence of extra-articular deformities or implants. J Bone Joint Surg Am. 2008; 90 (3): 45-51.
Chang JS, Haddad FS. Revision total hip arthroplasty for metal-on-metal failure. J Clin Orthop Trauma. 2020; 11 (1): 9-15.