A Rare Case of Titanium Elastic Nail Removal 7 Years after Pediatric Femoral Shaft Fracture Using a Screw Retriever Technique
Bibliographic record
Abstract
Introduction: Elastic stable intramedullary nailing is a commonly used modality for the surgical stabilization of long-bone fractures in children, with routine implant removal recommended within 6-12 months. Delayed removal beyond this timeframe is uncommon and presents unique surgical challenges. We report a rare case of titanium elastic nails (TENs) removal performed 7 years after initial fixation, highlighting the technical considerations and successful outcome. Case Report: A 14-year-old female presented with discomfort in the left thigh. The patient had a history of TENs nails inserted at age 7 for a mid-shaft femoral fracture. The patient was lost to follow-up due to family circumstances. The patient had remained completely asymptomatic throughout the retention period with full functional recovery. Radiograph of the left thigh showed two TENs nails. Due to anticipated extraction difficulty from prolonged retention, a screw retriever technique was successfully employed for safe nail removal without complications. Conclusion: This case demonstrates the excellent biocompatibility of titanium implants and confirms that delayed TENs removal can be safely accomplished using specialized extraction techniques. The use of a screw retriever provides an effective solution for challenging implant removal scenarios while minimizing surgical morbidity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".