title: Tibial intramedullary nails -- should they be removed? A retrospective study of 71 patients.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  The results of nail removal to alleviate pain are poor. Removal of a nail should not be undertaken unless there is a convincing indication.
authors.affiliation: Department of Orthopaedics, Sahlgrenska Hospital, Göteborg University, Sweden. akarladani@telia.com
authors.forename: Abbas H
authors.initials: AH
authors.lastname: Karladani
authors.forename: Per Ake
authors.initials: PA
authors.lastname: Ericsson
authors.forename: Hans
authors.initials: H
authors.lastname: Granhed
authors.forename: Lars
authors.initials: L
authors.lastname: Karlsson
authors.forename: Peter
authors.initials: P
authors.lastname: Nyberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000009:adverse effects; D020878:Device Removal; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome