Removal of broken drill bits and locking screws from an intramedullary nail

Description: Intramedullary nails are commonly used for internal fixation of long-bone fractures. When locking screws are used, both drill bits and screws may break at the time of insertion. Screws may also fail in situ, especially in the case of delayed or non-union. Both cause a problem should the nail require removal, resulting in a large, soft-tissue dissection and cortical disruption to retrieve the broken item. Although methods have been described to push a fractured screw into the surrounding soft tissue via the use of a k-wire1 or insertion of a new screw,2 we describe below a technique for complete removal via small stab incisions.
Removal of broken drill bits and locking screws from an intramedullary nail. Matthews SJ, Landsmeer RE, Thomas TL. Ann R Coll Surg Engl. 2006 May;88(3):316.