Tibial intramedullary nails -- should they be removed? A retrospective study of 71 patients.

Background Anterior knee pain and young age of the patient have been considered justification for removal of a tibial intramedullary nail. There have been few reports on the outcome after nail removal, however.Patients and methods We studied 71 patients in whom 72 tibial nails had been removed. We used self-assess-ment questionnaires to evaluate the location, intensity, and frequency of pain before and after removal. The degree of satisfaction was scored on a visual analog scale.Results 39 of 71 patients had less pain after removal of the nail, but were not asymptomatic. 14 patients had unaltered pain, and 18 patients had increased pain. 4 of 6 patients who had been treated with fasciotomy were not satisfied with the outcome of nail removal.Interpretation The results of nail removal to alleviate pain are poor. Removal of a nail should not be undertaken unless there is a convincing indication.