Difficulties in removing ACE tibial intramedullary nail

We experienced three cases of refracture and two cases of failure to remove the nail while trying to take out ACE tibial nails from healed tibial fractures. In order to determine the risk factors associated with difficulties in nail removal, these five patients were compared in the parameters of age, gender, duration of nail in situ, nail diameter, nail length, and level of fracture with 30 patients who had uneventful removal. Younger age of the patient was significantly associated with the difficulty in nail removal.