{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:40:25Z","timestamp":1756280425357,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,27]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>We present a case of a femoral head lag screw \u2018cold welded\u2019 to an intramedullary nail (IMN) in a female in her 20s during exchange femoral nailing of a subtrochanteric femoral osteotomy non-union. We subsequently developed a reverse spiral-fluted bolt extraction socket, designed to engage the outer wall of a bolt or screw. The lag screw was removed from the Smith and Nephew Meta-Tan IMN, 1\u2009week later, and exchange nailing was successfully completed. This case report describes a technically challenging situation of a cold-welded femoral head lag screw during a complex revision. This report introduces a novel removal device and technique for such cases.<\/jats:p>","DOI":"10.1136\/bcr-2024-264090","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:34:00Z","timestamp":1742956440000},"page":"e264090","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Removal of a \u2018cold-welded\u2019 femoral head lag screw in a nail combination"],"prefix":"10.1136","volume":"18","author":[{"given":"Ryan J","family":"Campbell","sequence":"first","affiliation":[{"name":"Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Symes","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"},{"name":"Orthopaedic Surgery, St George Hospital, Kogarah, NSW, Australia"},{"name":"St George and Sutherland Clinical School, University of New South Wales, Kogarah, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brahman","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"},{"name":"Orthopaedic Surgery, St George Hospital, Kogarah, NSW, Australia"},{"name":"Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"},{"name":"Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia"},{"name":"Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9874-6357","authenticated-orcid":false,"given":"Zac","family":"Dragan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Ruff","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"},{"name":"Orthopaedic Surgery, Dubbo Base Hospital, Dubbo, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Ellis","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"2025082700005561000_18.3.e264090.1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B7.36061"},{"key":"2025082700005561000_18.3.e264090.2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.5371\/hp.2017.29.3.199","article-title":"Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes","volume":"29","author":"Santoso","year":"2017","journal-title":"Hip Pelvis"},{"key":"2025082700005561000_18.3.e264090.3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4055\/cios.2015.7.2.261","article-title":"Breakage of a Lag Screw of Cephalomedullary Nail: A Technique of Removal","volume":"7","author":"Tantigate","year":"2015","journal-title":"Clin Orthop Surg"},{"key":"2025082700005561000_18.3.e264090.4","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.injury.2016.12.014","article-title":"Removal of a broken trigen intertan intertrochanteric antegrade nail","volume":"48","author":"Zheng","year":"2017","journal-title":"Injury"},{"key":"2025082700005561000_18.3.e264090.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.tcr.2021.100526","article-title":"Technical note on the removal of a \u201ccold-welded\u201d lag screw from a Trigen Meta-Tan nail","volume":"35","author":"Yanagisawa","year":"2021","journal-title":"Trauma Case Rep"},{"key":"2025082700005561000_18.3.e264090.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.10.034"},{"key":"2025082700005561000_18.3.e264090.7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.22271\/27078345.2023.v5.i2a.170","article-title":"A rare case of multifocal osteonecrosis of the femur in a heart transplant patient","volume":"5","author":"Campbell","year":"2023","journal-title":"Int J Case Rep Orthop"},{"key":"2025082700005561000_18.3.e264090.8","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/j.injury.2010.12.025","article-title":"Removal technique for cold-welded titanium locking screws","volume":"42","author":"Lehmen","year":"2011","journal-title":"Injury"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:01:02Z","timestamp":1756278062000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2024-264090"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264090","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}