Removal of a Bent Locked Intramedullary Nail from the Femur a Case Report

Abstract

Introduction: The issue of deformation of a secured femoral intramedullary nail following recurrent injury is uncommon and can complicate standard removal procedures. The difficulty escalates in regions without specialised metal-cutting machinery.
Case Presentation: A 28-year-old woman sustained a left femoral shaft fracture following a road traffic accident in November 2025. She underwent open reduction and internal fixation using a hollow 9 × 360 mm stainless-steel locked intramedullary nail manufactured by Nebula Surgical Pvt. Ltd. She was discharged on the fifth postoperative day but subsequently fell at home and bent the implant. Radiographs demonstrated a 25° bend involving a 12.5 cm segment of the nail. Revision surgery was performed six months after the reinjury. A Gigli saw failed to create an indentation in the implant, while a giant rod cutter compressed and partially collapsed the nail without transecting it. A conventional hacksaw was then used successfully to divide and remove the nail. Revision fixation was performed using an 11 × 375 mm stainless-steel locked intramedullary nail from the same manufacturer.