IMPLANT REMOVAL : AN UNSOLVED CHALLENGE TO ORTHOPAEDICIAN

Its general consciences amongst the Orthopaedicians, that Implant removal is a challenging one. Newer generation is not aware of implants used in the past & if there is any patient where its removal is indicated it becomes a challenge. Unavailability of necessary & proper instruments as extractor or hook makes the task difficult. Surgeon has to rely on his mechanical skill, modification in procedure, and way of thinking in tackling the situation in present scenario with whatever things are there on trolley & in the armamentarium. We are presenting a case of intramedullary tibial implant – two V nails, put about 8 years ago having pain &sinus in upper third of leg. It was difficult to predict radiologically the nature of the intramedullary implant & hence, difficulties during its removal. It is mandatory to discuss all the possible options with the patient and relatives prior to surgery. It is also necessary to explain at times, we might not be able to remove the implant and procedure have to be abandoned. The patient usually considers the removal of implant to be easier than the initial surgery and is usually unaware of the difficulties that can be encountered during removal and the fact that it may need a major procedure followed by a prolonged recovery time.