Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 1 2021 04 20 27 30 Mahlisha Kazemi Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammadhasan Sharafi Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ramin Shayan-Moghadam Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2020 11 09 2021 03 29 Background: Interlocked intramedullary nailing is the most common treatment for closed tibial fractures. Reaming is a fundamental step in this surgical technique, and reamer breakage is a rare yet challenging complication during this operation.   Case Report: A 34-year old male with a tibial shaft fracture was admitted for early closed tibial nailing. During the reaming process, the reamer broke and stuck in the medulla at the isthmus level. We extracted the broken piece by back hammering a cannulated T-handle placed on the ball tip guide pin.   Conclusion: In this closed and quick method, we did not use any extra device other than standard equipment of intramedullary nailing. https://jost.tums.ac.ir/index.php/jost/article/view/235 https://jost.tums.ac.ir/index.php/jost/article/download/235/214