There isn’t enough anesthesia in the world!

What you are looking at is video of the Skula Winquist IM Nail Removal System in action. And while it may seem like an outdated procedure performed by 19th-century surgeons, it is actually the standard of practice for taking out rods that support healing fractured long bones, including the tibia, fibula, humerus, and femur.

As you can see, this surgical procedure involves a surgeon swinging a hammer at full force to drive a rod from this poor patient’s leg. Although it is unknown which type of shaft fracture this particular patient suffered, the tibia, also known as our shinbone, is the most commonly fractured long bone in the human body.

Long bone fractures can be caused by both high-energy collisions, such as car and motorcycle accidents, or low-energy collisions, like sports injuries. If a fracture is open, unstable due to bone fragments and displacement, and cannot be healed with nonsurgical techniques, doctors will often recommend intramedullary nailing.

This is the most popular form of surgical treatment for tibial fractures. Surgeons insert a specially designed metal rod into the canal of the tibia through the front of the knee. The rod goes across the fracture to prevent it from moving out of place while a nail is screwed to the bone at both ends to keep everything in position as it heals.

Clearly, this type of treatment is not ideal for children and adolescents due to the extraction method and because it takes a lot to care for. However, it does increase an adult’s chances that the bone stays in position during recovery — even if getting it out looks like a scene from Game Of Thrones .