The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Intertrochanteric Fracture With Broken Proximal Femoral Nail – A Case Report With Tips & Tricks


Affiliations
1 KLE Academy of Higher Education & Research, J N Medical College, Belagavi, Karnataka, India
     

   Subscribe/Renew Journal


Background: Intertrochanteric (IT) femur fractures comprise approximately half of all hip fractures caused by a lowenergy accident such as a fall from standing height. These fragile hip fractures occur in a characteristic population with risk factors including increasing age, female gender, osteoporosis, a history of falls, and gait abnormalities. Surgery is almost always the recommended treatment as the morbidity and mortality associated with non-operative treatment historically has been high.

Case Report: A 75-year-old male with left sided hemiplegia developed left intertrochanteric fracture after he fell as his own. He was treated with short proximal femoral nailing and was discharged. After 3 weeks he fell again and broke his implant with refracture. He was treated with implant removal and long proximal femoral locking compression plate with bone graft. After 6 months and 1 year of follow up, fracture was found united and the patient was walking comfortably.

Conclusion: The quality of fracture reduction is an important factor that affects the revision rate in patients with mechanical complications after proximal femoral nail (PFN) was used for trochanteric fractures.


Keywords

Intertrochanteric Fracture, Broken Proximal Femoral Nail, Proximal Femoral Locking Compression Plate.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Appelt A, Suhm N, Baier M, Meeder PJ. Complications after intramedullary stabilization of proximal femur fractures: a retrospective analysis of 178 patients. Eur J Trauma Emerg Surg. 2007;33(3):262–267.

  • Fogagnolo F, Kfuri M Jr, Paccola CA. Intramedullary fixation of pertrochanteric hip fractures with the short AOASIF proximal femoral nail. Arch Orthop Trauma Surg.2004;124(1):31– 37.

  • Schipper IB, Steyerberg EW, Castelein RM, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br. 2004;86(1):86–94.

  • Simmermacher RK, Bosch AM, Van der Werken C. The AO/ASIFproximal femoral nail (PFN): a new device for the treatment of unstable proximal femoral fractures. Injury.1999;30(5):327–332.

  • Liu JJ, Shan LC, Deng BY, Wang JG, Zhu W, Cai ZD. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients. Genet Mol Res. 2014 Jan 1;13(3):5949-56.


Abstract Views: 282

PDF Views: 0




  • Intertrochanteric Fracture With Broken Proximal Femoral Nail – A Case Report With Tips & Tricks

Abstract Views: 282  |  PDF Views: 0

Authors

Sameer Haveri
KLE Academy of Higher Education & Research, J N Medical College, Belagavi, Karnataka, India
Pulkit Bandi
KLE Academy of Higher Education & Research, J N Medical College, Belagavi, Karnataka, India

Abstract


Background: Intertrochanteric (IT) femur fractures comprise approximately half of all hip fractures caused by a lowenergy accident such as a fall from standing height. These fragile hip fractures occur in a characteristic population with risk factors including increasing age, female gender, osteoporosis, a history of falls, and gait abnormalities. Surgery is almost always the recommended treatment as the morbidity and mortality associated with non-operative treatment historically has been high.

Case Report: A 75-year-old male with left sided hemiplegia developed left intertrochanteric fracture after he fell as his own. He was treated with short proximal femoral nailing and was discharged. After 3 weeks he fell again and broke his implant with refracture. He was treated with implant removal and long proximal femoral locking compression plate with bone graft. After 6 months and 1 year of follow up, fracture was found united and the patient was walking comfortably.

Conclusion: The quality of fracture reduction is an important factor that affects the revision rate in patients with mechanical complications after proximal femoral nail (PFN) was used for trochanteric fractures.


Keywords


Intertrochanteric Fracture, Broken Proximal Femoral Nail, Proximal Femoral Locking Compression Plate.

References