As tibial intramedullary nailing becomes the preferred treatment for tibial
shaft fracture, removal of tibial nails will become more common. Removal o
f tibial intramedullary nails is not without complications, but a review of
the literature found only one recent report of a fracture of the tibia dur
ing removal. A case report of a tibial fracture during removal of an Alta t
ibial nail is presented.