An Unusual Case of “Late” Central Protrusion of the Helical Blade of Proximal Femoral Nail Antirotation

• Published in: Journal of orthopaedics, trauma and rehabilitation Vol. 18; no. 2; pp. 124 - 127
• Main Authors: Yip, Kun-Chow, Hsu Stephen, Yun-Chiang, Wong, Hin-Keung
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2014; SAGE Publishing
• Subjects: fracture fixation; hip fractures; intramedullary; postoperative complications; postoperative complications; intramedullary; hip fractures; fracture fixation
• ISSN: 2210-4917; 2210-4925
• DOI: 10.1016/j.jotr.2013.09.004

Central protrusion, or “cut-through” of the helical blade in proximal femoral nail antirotation (PFNA), is a unique and novel complication. Cases reported in the literature were presented early in the postoperative period and were associated with no bone healing, and managed with either revision or total hip replacement. We reported a case that presented late in the postoperative period that showed some bone healing and was erroneously treated with removal of the implant, resulting in varus malunion after implant removal. Possible causes for late presentation, preventive measures, and the need for early surgical intervention are discussed. 防旋型股骨近端髓內釘的螺旋狀刀片中央突出的或切出，是獨特和新的併發症。早前文獻主要描述術後”早期”的病例 ，我們報告一個”晚期” 的病例，並討論它的成因和預防方法。