Tibial intramedullary nails - should they be removed

Description: BACKGROUND: Anterior knee pain and young age of the patient have been considered justification for removal of a tibial intramedullary nail. There have been few reports on the outcome after nail removal, however. PATIENTS AND METHODS: We studied 71 patients in whom 72 tibial nails had been removed. We used self-assess-ment questionnaires to evaluate the location, intensity, and frequency of pain before and after removal. The degree of satisfaction was scored on a visual analog scale. RESULTS: 39 of 71 patients had less pain after removal of the nail, but were not asymptomatic. 14 patients had unaltered pain, and 18 patients had increased pain. 4 of 6 patients who had been treated with fasciotomy were not satisfied with the outcome of nail removal. INTERPRETATION: The results of nail removal to alleviate pain are poor. Removal of a nail should not be undertaken unless there is a convincing indication.
Tibial intramedullary nails -- should they be removed? A retrospective study of 71 patients. Karladani AH, Ericsson PA, Granhed H, Karlsson L, Nyberg P. Acta Orthop. 2007 Oct;78(5):668-71.