A Novel Surgical Technique for the Extraction of a Broken, Incarcerated Intramedullary Reamer

The breakage of intramedullary implants and instruments is a rare but challenging surgical complication.Traditional retrieval methods, such as invasive osteotomy or specialized kits, are associated with increased morbidity and may not be universally available.We present the technical description of a surgical method, based on a case of a 30-year-old male patient with a broken, cannulated, intramedullary reamer in a fractured femur.The technique involves creating a distal entry point in the intercondylar notch, passing the plain end of a ball-tipped guide wire retrograde sequentially through the reamer's cannulation, the fracture site, the proximal fracture segment, and the piriformis fossa using a T-handle to push the reamer out of the proximal surgical wound.The described technique resulted in the successful and complete removal of the broken reamer.The procedure was performed without the need for a cortical osteotomy, effectively leveraging the reamer's cannulation and avoiding a more invasive approach, preventing the loss of fracture hematoma.This novel retrograde technique is a safe and effective alternative for extracting broken, cannulated, intramedullary instrumentation.The core principles of this technique may be extrapolated to manage similar unexpected complications in other long bone fracture surgeries.This case highlights the value of adaptable, non-invasive solutions to complex intra-operative challenges.