Case Report: Traumatic Incomplete Fracture of an Implanon NXT® Contraceptive Implant

Rebecca Howett, Alida M Gertz, Tiroyaone Kgaswanyane, Gregory Petro, Chelsea Morroni


The etonogestrel (ENG) subdermal contraceptive implant (Implanon NXT® ) is a safe and highly effective method of contraception which is increasing in popularity globally. This case report describes a 26-year-old woman who requested removal of the Implanon NXT® contraceptive implant. She reported that her implant had bent following direct trauma. The implant was removed in accordance with her request and without complication, but was noted to be incompletely fractured. We compare this case with a summary of the existing literature on fractured or damaged contraceptive implants. Structural damage detected whilst the implant is in situ is one potential complication of contraceptive implant use. The incidence of this complication and the implications for contraceptive efficacy are unknown. Damaged implants may present healthcare providers with more technically challenging ―difficult removals‖. With the scale-up of services for implant provision, consideration should be given to this issue in order to inform counselling and removal services. (Afr J Reprod Health 2019; 23[4]: 124-128).

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Merck. Nexplanon prescribing information,

nexplanon/nexplanon_pi.pdf [accessed 11 May 2019].

Crouthamel BC, Schiff MA, Amies Oelschlager AE, Prager SW and Debiec KE. Bits and pieces: a

crowd-sourced series of 54 cases of fractured hormonal implants. J Pediatr Adolesc Gynecol

; 31(2):128-131.

Pickard S and Bacon L. Persistent vaginal bleeding in a patient with a broken Implanon® . J Fam Plann Reprod Health Care 2002; 28(4):207-208.

Tomas-Tello MD and Hodgson G. Two cases of broken Implanon® . J Fam Plann Reprod Health Care 2010; 36(4):255.

Bentley J. Experience and removal of damaged implants. J Fam Plann Reprod Health Care 2013; 39:233-234.

Torres R, Mendes N, Machado AI and Marques C. In situ breakage of Implanon® – two cases of a rare

occurrence. Contraception 2013; 88:189-191.

Campodonico J, Wolfrey J and Buchanan J. Reports of Two Broken Nexplanon®

Rods. J Am Board Fam Med 2019; 32(2):269-271.

Agrawal A and Robinson C. Spontaneous snapping of an Implanon® in two halves in situ. J Fam Plann Reprod Health Care 2003; 29(4):238.

Doshi J. Bent Implanon® . J Fam Plann Reprod Health Care 2011; 37:126.

Elliman A. Removal of a fractured Nexplanon® . J Fam Plann Reprod Health Care 2013; 39:66-67.

Khatri D. Fractured Nexplanon® implant. J Fam Plann Reprod Health Care 2015; 41:77.

Hartnell V. Incidence of fractured implants. J Fam Plann Reprod Health Care 2015; 41:157.

Rowlands S and Seattle S. Contraceptive implants: current perspectives. Open Access Journal of

Contraception 2014; 5:73-84.

Bayer. Jadelle prescribing information,

bel/2016/020544s010lbl.pdf [accessed 11 May 2019].

Dunson TR, Amatya RN and Krueger SL. Complications and risk factors associated with the removal of

Norplant implants. Obstet Gynecol 1995; 85:543- 548.

Rekers H. Removal of a fractured Nexplanon®: MSD response. J Fam Plann Reprod Health Care 2013;


Jacobstein, R. Liftoff: The Blossoming of Contraceptive Implant Use in Africa. Global Health, Science and Practice 2018; 6(1):17-39.

Petro G. Non-palpable and difficult contraceptive implant removals: The New Somerset Hospital referral

clinic experience. S Afr J Obstet Gynaecol 2017; 23(3):101-104.


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