A Novel Technique for Percutaneous Removal of a Suprapatellar Intramedullary Nail

Intramedullary nailing (IMN) of tibial shaft fractures is an excellent treatment option associated with low complication rates. Suprapatellar intramedullary nailing (SIMN) is a viable alternative treatment to traditional IMN, especially for proximal fractures of the tibia. There are, however, clinical concerns regarding SIMN removal that pose a challenge to a successful outcome. This article describes a novel percutaneous technique for the removal of a SIMN using the same instruments and incision used for nail insertion. This technical innovation offers a simple, reliable, and minimally invasive approach for the removal of any IMN, including nails inserted via a suprapatellar approach. The technique is demonstrated here on a cadaveric specimen as well as with a sawbones model.