title: Removal of femoral Kuntscher nails in selected cases under local anaesthesia.
abstract: A preliminary study of fifteen patients undergoing extraction of Kuntscher nails after fracture surgery under local anaesthesia indicated varying behavioural responses and tolerance of the procedure. In the main study cohort, of 59 patients within the age range of 16-65 years, made up of 41 males and 18 females, 38 patients (64.4%) tolerated the procedure without discomfort, 14 patients (23.7%) experienced mild to moderate pain, while the remaining seven patients (11.9%), pain and discomfort was severe enough to require the additional use of intravenous anaesthesia (ketamine hydrochloride). There were no significant complications post-operatively. Financial considerations are assuming a greater importance, since planned procedures for osteosynthetic metal implants removal contribute considerably to the waiting lists for elective surgery. We conclude that there are clear advantages in removal of Kuntscher nails under local anaesthesia and it is also noteworthy that the compliance rate amongst our patients has been on the increase, as this method offers shorter waiting period, immediate ambulation, is a day procedure with early return to work and lower monetary costs. We are unaware of existing prospective work on the extraction of Kuntscher nails under local anaesthesia.
authors.affiliation: University of Benin, Nigeria.
authors.forename: O N
authors.initials: ON
authors.lastname: Onwuanyi
authors.forename: H A
authors.initials: HA
authors.lastname: Omotosho
authors.forename: K A
authors.initials: KA
authors.lastname: Habeeb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D000772:Anesthesia, Local / Q000009:adverse effects; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies