A rare complication of pelvic perforation by an excessive medial slide of the helical blade after treatment of an intertrochanteric fracture with proximal femoral nail anti-rotation: A case report and literature review

Chinese Journal of Traumatology

Dian-Ying Zhang¹  Xiao-Kun Chen²  Jian Xiong²  Quan Han²  Tian-Bing Wang²  Yi-Jun Liu² 

[1] Trauma Center, National Center for Trauma Medicine, Key Laboratory of Trauma and Neural Regeneration, Peking University People's Hospital, Beijing, 100044, China;Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, 100044, China;

关键词: Hip fractures;    Intertrochanteric fractures;    Proximal femoral nail anti-rotation;    Complication;    Pelvic perforation;    Case report;   

DOI  :  

来源: DOAJ

【 摘 要 】

Intertrochanteric fractures have become a severe public health problem in elderly patients. Proximal femoral nail anti-rotation (PFNA) is a commonly used intramedullary fixation device for unstable intertrochanteric fractures. Pelvic perforation by cephalic screw is a rare complication. We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture. The patient underwent surgery with PFNA as the intramedullary fixation device. Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation. We performed a cemented total hip arthroplasty as the savage procedure. At the latest follow-up of 12 months after total hip arthroplasty, the patient had no pain or loosening of the prosthesis in the left hip. Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device, especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation. The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.

【 授权许可】

Unknown