Sometimes we experience refracture of tibia during removal of ILMN after complete union of fracture. We evaluated surgical technique in order to know how we can avoid the fracture of posterior cortex of tibia during removal of ILMN.

From Jan. 1993 to Dec. 1999, we removed 86 cases of ILMN used for tibia fracture. Among them, 40 cases of Ace titanium ILMN were removed. We compared the fracture rate of tibia during removal of Ace titanium ILMN.

The refracture rate during removal of Ace titanium ILMN was 17.2% (5/29cases) previously, but after careful "slow and steady" removal of nail, the refracture rate was reduced to 0%(0/11 cases, P<0.05).

Take some cares during removal of ILMN is important to reduce the fracture rate of tibia during removal of Ace titanium ILMN.