Technical Notes and Tips: A Simple Technique for Easy Removal of Titanium Elastic Nails

Titanium elastic nails are becoming increasingly popular in the treatment of paediatric long bone fractures. Once inserted, the nails are buried under the skin to reduce the risk of infection. In order to avoid tenting the skin and causing irritation, they are often cut off close to the bone before the stab incision is closed over the top. However, this may cause problems as the tip of the nail is difficult to grip when trying to remove the nail. This is facilitated by the use of a free-hand hollow reamer, from the damaged screw set. These can be matched to the size of the nail. The drill tip is inserted over the tip of the nail to clear any bony growth and to clear the tip of the nail. The hollow reamer can also be used to add a slight bend to the tip of the nail to enable easier grasping. Figure 1 Intra-operative radiographs of a paediatric radius and ulna titanium elastic nails. (A) Prior to removal of nail. (B) The hollow reamer being inserted over the tip of the nail. (C) The increase in bend on the tip can clearly be seen. (D) Easy grasping ...