Femoral Nail Removal Should Be Restricted in Asymptomatic Patients.Gösling, Thomas MD; Hufner, Tobias MD; Hankemeier, Stefan MD; Zelle, Boris A MD; Muller-Heine, Assia MD; Krettek, Christian FRACSAuthor Information From the Department of Trauma Surgery, Hannover Medical School, Hannover, Germany. Received: June 2, 2003 Revised: September 22, 2003; December 12, 2003 Accepted: February 3, 2004 Correspondence to: Dr. Thomas Gösling, Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Phone: 49-511-532 2026; Fax: 49-511-532 5877; E-Mail: [email protected] Clinical Orthopaedics and Related Research (1976-2007): June 2004 - Volume 423 - Issue - pp 222-226 doi: 10.1097/01.blo.0000130208.90879.67 Buy Metrics Abstract Femoral nail removal has been suggested as a routine procedure for symptomatic and asymptomatic patients. The aim of this study was to evaluate whether asymptomatic patients have long-term complaints after femoral nail removal. Additionally, factors that might extend operation time and effect soft tissue healing negatively were analyzed. A retrospective study on the removal of 164 femoral nails after fracture consolidation was done. A review of the patient charts and radiographs was done. Neither the interval between nail implantation and nail removal or the use of an end-cap significantly influenced the operation time. The surgeon's qualification and nail depth were the only variables that influenced operation time. Neither operation time, nail depth, surgeon's qualification, nor the grade of heterotopic ossification significantly influenced the incidence of wound healing problems. One hundred nine patients (73%) were available for the followup interview. Preoperatively, 58 patients (53%) had local complaints. Of these 58 patients, 78% reported improvement and 7% reported an aggravation of their local complaints. Of the 51 patients who were asymptomatic before surgery, 20% reported long-term complaints at followup. Only symptomatic patients should be considered for femoral nail removal. © 2004 Lippincott Williams & Wilkins, Inc.