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‘Extended tibia osteotomy’: a technical tip for removal of incarcerated reamer with broken guide wire bead during tibia nailing and literature review
  1. Pulak Vatsya1,
  2. Samarth Mittal1,
  3. Aashraya Karpe2 and
  4. Vivek Trikha1
  1. 1Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Opthalmology, Dr Shroff's Charity Eye Hospital Delhi, New Delhi, India
  1. Correspondence to Professor Vivek Trikha; vivektrikha{at}


Intramedullary nailing has become a standard of care for tibia fractures. Reaming is an essential part of this technique due to its multiple advantages like a better fit and earlier union. In young bone, with a narrow cortical canal, incarceration and breakage of reamer is a possibility. This can be removed with a ball-tip guidewire. In our case, the broken incarcerated reamer was complicated by a broken ball-tip of the guidewire, leading us to invent a novel medial tibial osteotomy window for the reamer removal. This can be a handy tool for a stuck surgeon intraoperatively.

  • trauma
  • orthopaedics

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  • Contributors SM and PV were the operating surgeons. VT came up with the idea to perform a medial tibial osteotomy to remove the reamer. PV and AK wrote the first manuscript. VT and SM edited and proofread the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.