Jinxi Hu1*,Fei Wen2*, Wenbin Chen3, Ping Wang3

1Department of Orthopedic, Yueyang Affiliated Hospital of Hunan Normal University, Yueyang, China
2Department of Orthopedic, People`s Hospital of Rongchang District, Chongqing, China
3Department of Anatomy, Tarim University School of Medicine, Alaer, China

Keywords: Antegrade, broken nail removal, cerclage wire, proximal femoral intramedullary nail, proximal femoral nail.


Proximal femoral nail (PFN) fixation is a technique widely used to treat various femoral fractures, but femoral re-injury may occur, leading to PFN breakage. Broken nail removal, particularly removal of the distal broken nails, is usually challenging. Herein, we describe a feasible approach to successfully remove broken femoral intramedullary nails in three sites (proximal, middle, and distal section) of the PFN. Three patients required surgery for PFN breakage. We performed a novel technique using minimal exposure and a cerclage wire to remove the PFN fragment, which a distal knot on the wire was applied to hold the PFN fragment, and the removal trajectory was completed through the minimal exposure, a distal femoral bone window, and the marrow cavity. We successfully operated these three patients and removed the PFN fragments rapidly and effectively. In conclusion, this novel technique is rapid, feasible, and cost-effective, and can also be promising in removing intramedullary nail breakages in other long bones.

* The first two authors contributed equally to this manuscript.

Citation: Hu J, Wen F, Chen W, Wang P. A novel feasible technique for rapid removal of broken proximal femoral nails: A case series. Jt Dis Relat Surg 2023;34(2):463-468. doi: 10.52312/jdrs.2023.873.

Author Contributions

Manuscript drafting: J.H., F.W., W.C., P.W.; Data collection: J.H., F.W., W.C.; Data analysis: W.P., F.W.; Study design: J.H., F.W., P.W.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This study was partially supported by the President program of Tarim University with the grant number TDZKSS202237 (P.W.) and the Health Commission of Chongqing (2022WSJK063, F.W.).

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.