Closed Management of a Bent Tibial Nail: Can Revision Be Avoided?
Authors: Johanna Mousley, Richard Kjar, Michael Reidy, Anton Lambers
Site: Northeast Health Wangaratta, VIC
Dr Lambers performed a rare case of closed reduction on a bent leg in a patient who had a broken tibia (leg bone) with a bent rod inside from a previous injury. This involved bending the leg back straight with the patient asleep, without any cuts to the skin. Interestingly, Dr Lambers had published on a similar case of the wrist several years prior.
In searching for solutions for this case when the patient was injured, Dr Lambers found no reports published on bending the nail back without invasive surgery. After careful evaluation of the pros and cons of each option with the patient, including removal of the implant and re-doing the fixation, it was decided that if it could be bent back straight it should be managed without open surgery. Mick the theatre tech came up with the idea of the padded F-tool to do this in a controlled fashion.
This was the first time this had been described as a treatment strategy for this unique situation and was published as a case report so that others around the world may use the information and excellent outcomes for the patient to guide their own decision making in the future.
