J Korean Fract Soc.  2013 Apr;26(2):151-155. 10.12671/jkfs.2013.26.2.151.

Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -

• Park BJ
• Cho HM
• Kim JH
• Sin WJ

• KMID: 1496171
• DOI: http://doi.org/10.12671/jkfs.2013.26.2.151

Abstract

Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.

Keyword

Femur; Proximal fracture; Proximal femoral nail anti-rotation (PFNA); Sliding

MeSH Terms

Femoral Neck Fractures
Femur
Femur Neck
Hip Fractures
Nails
Orthopedics

Figure

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  Fig. 1 An 83-year-old male with right hip pain. (A) Preoperative radiology showed AO/OTA type A2.2 intertrochanteric fracture. (B) Preoperative 3-dimensional computerized tomography showed AO/OTA type A2.2 intertrochanteric fracture. (C) Immediate postoperative radiology showed fixation with proximal femoral nail anti-rotation. (D) Radiologic finding on his postoperative 16 weeks showed slight sliding of the helical blade.

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  Fig. 2 (A) Anteroposterior radiograph taken 20 weeks after the operation showing back-out of the helical blade and femur neck fracture. (B) Bipolar hemiarthroplasty was done.

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  Fig. 3 (A) The retrieved femoral head showing subcapital femur neck fracture. (B) Biopsy finding was normal mature trabecular bone and marrow fat tissue (H&E, ×40).

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