Extracting the Nail, contd.

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Extracting the Nail, Stepped procedures

1.   Make an incision at the nail entry point (for the tibia, see tibial nail insertion section of this guide; for the femur, see femoral nail insertion section of this guide).

2.   Expose the nail end and remove all tissue ingrowth from the threads, using a curette and sharp hook.

3.   Using the socket wrench, tightly screw the appropriate conical bolt into the proximal end of the nail.

4.   Slide the Ram over the Ram Guide, keeping the weighted end proximal. Attach the Flexible Grip onto the proximal end of the Ram Guide. Screw this assembly onto the conical bolt.

5.   With controlled blows of the Ram against the Flexible Grip, extract the nail. It is often necessary to retighten the conical bolt with the Combination Wrench. This compensates for any loosening of the threaded connections due to residual tissue ingrowth or nail deformation, and will prevent stripping of the threads.

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