Removal of a broken nail using a guide wire and a screw

Description: An 80-year-old man sustained a closed displaced comminuted subtrochanteric fracture in a fall accident. The fracture was stabilized with a Long Gamma locking nail (Stryker Trauma, Schnkirchen, Germany). Postoperative radiographs showed good placement of the nail and acceptable fracture alignment, but also significant bone loss beneath the calcar. Postoperatively, the patient was allowed to walk using crutches and partial weight bearing. At 6-month follow-up the patient complained about severe pain and reduced walking ability since several days. Radiographs showed nonunion and breakage of the nail through the hip screw hole (Figure 1). There was no history of new trauma. The nail was changed to a Trigen trochanteric antegrade nail (Smith & Nephew Orthopedics, Memphis, TN).
Removal of a broken nail using a guide wire and a screw. Karladani AH. Acta Orthop. 2006 Dec;77(6):986-8.