title: [Modfied technique for intramedullary femur nail removal].
abstract: BACKGROUND
  The indication of implant removal of intramedullary nails is a subject of much discussion. The main concern is the increased morbidity of the preparation of the proximal nail end which can cause postoperative discomfort. The aim of the present study was to develop a soft-tissue protecting extraction technique and to evaluate it in comparison to the standard procedure.
  
  
  METHODS
  With the modified technique the proximal end of the nail is preparated by a guidewire and the standard reamer used for implantation. This allows a soft-tissue protection with reduced morbidity, especially in patients with ossification. The outcome was assessed 4-20 weeks postoperatively and the operation times compared with those of 10 patients operated with the conventional technique.
  
  
  RESULTS
  From 5/09 to 12/10 we treated 9 patients with the mentioned technique. The operation time was reduced from a mean of 74.8 minutes to 32.0 minutes. Eight of nine patients had reduced or no discomfort postoperatively. Eight of nine patients stated that they had a benefit from the operation.
  
  
  CONCLUSIONS
  The modified operation technique is capable of reducing operation time and morbidity in the implant removal of intramedullary nails.
authors.affiliation: Orthopädie und Unfallchirurgie, Klinikum Duisburg. ole.ackermann@klinikum-duisburg.de
authors.forename: O
authors.initials: O
authors.lastname: Ackermann
authors.forename: K
authors.initials: K
authors.lastname: Maier
authors.forename: C
authors.initials: C
authors.lastname: Ruelander
authors.forename: T
authors.initials: T
authors.lastname: Vogel
authors.forename: M
authors.initials: M
authors.lastname: Schofer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000601:surgery; D056888:Patient Positioning; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation / Q000379:methods; D017695:Soft Tissue Injuries / Q000517:prevention & control; D013525:Surgical Instruments; D013996:Time and Motion Studies