Retrieval of a Broken Cannulated Drill Bit from the Femoral Neck during Proximal Femoral Nailing: Case Report of a Novel Lever Technique Using a Depth Gauge
Year: 2026
Type: article
Abstract: Introduction: Intraoperative drill bit breakage is a recognised complication in orthopaedic trauma surgery. Although retained broken drill bits embedded deep within bone are generally considered benign, their removal becomes mandatory when they obstruct optimal implant placement for fracture fixation, risk migration, or carry medicolegal implications. Case Report: We describe the case of a male patient in his mid-sixties who sustained a left intertrochanteric femur fracture and underwent proximal femoral nailing (PFN). During reaming for the compression screw, an 8 mm cannulated drill bit fractured and became lodged within the femoral neck over the guide wire. A novel lever technique using a standard PFN-set depth gauge was employed. The hooked tip of the depth gauge was passed through the lumen of the broken cannulated drill bit under fluoroscopic guidance. The instrument was then rotated so that the hook faced medially, and the external arm was levered laterally away from the limb to engage the hook firmly against the medial wall of the broken fragment. Gentle traction successfully retrieved the drill bit, allowing completion of fracture fixation with a new drill bit in the optimal tip-apex position. Conclusion: This technique is safe, reproducible, and time-efficient. It requires no additional incisions, no specialized instrumentation beyond the standard PFN set, and provides secure mechanical engagement of the fragment before extraction. We recommend this approach for similar intraoperative situations.
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225592924
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