The authors report their experience and analyze the risk factors associated with difficulties in the removal of tibial intramedullary nails.

During the period from January 1996 to March 2001, 35 ACE® intramedullary nails were removed from healed tibial fractures. The authors analyzed risk factors associated with difficulties in nail removal. The five patients who had difficulties (Group I) were compared with 30 patients who had uneventful removal (Group II) in parameters of age, gender, duration of nail in situ, nail diameter, nail length, and the level of fracture.

Younger age of patients (p=0.04) was the only significantly associated risk factors. Gender (p=0.61), the duration of time in situ (p=0.20), nail diameter (p=0.41), the length of nail (p=0.31) and the level of fracture (p=0.22) were not associated risk factors.

It is suggested that patients undergoing the removal of ACE nails must be warned of possible difficulties that may be encountered.