Evaluation of a modified technique for gamma nail removal

Christoph von Schulze Pellengahr, ole Ackermann, Lothar Roslawski

Abstract


Question

The indication for removing intramedullary nails in young patients is controversial. The principal reason for this is the comparably high OP morbidity, which basically results from the exposing of the nail head and may cause postoperative symptoms. The aim of this study was to develop a nail explantation technique that protects the bones and soft tissue, and then evaluate it in comparison to the conventional technique.

Material and methods

In the modified technique, the nail head is exposed via a targeting wire and the hand reamer of the nail instrumentarium under soft tissue protection, thus reducing the access morbidity compared to the conventional surgical method.

The result of the operation was recorded based on a follow-up examination of the patients and the incision-suture time compared to the conventional operation.

Results

In the period from 5th September to 3rd October, the explantation was conducted with the new technique for 5 patients. The comparison ensued with 10 patients treated conventionally beforehand. The new technique revealed a significantly reduced mean OP time (31.0 against 74.8 minutes). All of the patients had less or no symptoms postoperatively in comparison to the findings before the metal removal. All of the patients stated that the operation had beneficial results for them.

Conclusions

The modified technique used in the operation with existing instrumentarium resulted both in a lowering of nail removal morbidity and a significant reduction in the operation time.

 

 


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DOI: http://dx.doi.org/10.15383/jmio.10

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