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

2021 ◽  
Author(s):  
Xiao-Kun Chen ◽  
Jian Xiong ◽  
Yi-Jun Liu ◽  
Quan Han ◽  
Tian-Bing Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Intertrochanteric Fracture ◽  
Rare Complication ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Helical Blade

Avoid to over-unlocking the helical blade in proximal femoral nail anti-rotation: a case report and literature review

2020 ◽  
Author(s):  
Wenchen Ji ◽  
Kai Liu ◽  
Meng Li
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Femoral Neck ◽  
Intertrochanteric Fracture ◽  
Lateral Wall ◽  
Treatment Method ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Intraoperative Fluoroscopy ◽  
Helical Blade

Abstract Purpose To discuss the reason and treatment method of helical blade over-unlocking. Methods The case reported in this paper is that the helical blade cannot be locked due to over-unlocking during the treatment of intertrochanteric fracture with PFNA, which is very rare. We expound why it happens and how to deal with it. Results When the helical blade is over-unlocking, if the aiming arm is not disassembled, you can try to take out the helical blade and fix it again. If the aiming arm has been removed, it is not recommended to remove the helical blade, we suggest that we should consider adding a screw from the lateral wall through the femoral neck for anti-rotation, or you can observe the tail of helical blade and find suitable screw driver to fix it if there is one. Conclusions In order to avoid over-unlocking of the helical blade, intraoperative fluoroscopy should not only pay attention to the position of the helical blade, but also pay more attention to the abnormal shape of the helical blade itself. Once the helical blade is over-unlocking, it needs to be handled in time.

scholarly journals Outcomes of Subcapital Femoral Fracture after a Fixation of an Intertrochanteric Fracture with a Proximal Femoral Nail: Case Report

2021 ◽  
pp. 56-61
Author(s):  
Jorge H. Nuñez ◽  
Jordi Teixidor ◽  
Felipe Borim ◽  
Vicente Molero ◽  
Jordi Tomas
Keyword(s):  
Case Report ◽  
Femoral Fracture ◽  
Intertrochanteric Fracture ◽  
Rare Complication ◽  
Femoral Fractures ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Number Of Patients ◽  
Neck Fracture

Proximal femoral fractures are a common injury that represents an important cause of hospitalization, morbidity, and mortality in elderly patients. Subcapital femoral neck fracture after fixation of an intertrochanteric fracture with a proximal femoral nail is an extremely rare complication. However, because of the large and steadily increase in the number of patients undergoing to proximal femoral nail fixation in recent years, we believe that the number of these cases could increase over time. We present a 78-year-old woman with a subcapital femoral fracture 11 months after a fixation of intertrochanteric fracture with a proximal femoral nail in the same hip. Five years of follow-up was presented. Also through our case report a review of literature of these rare cases was done, trying to evaluate the associated risk factors, the difficulties in their treatment and the final follow-up of these patients.

scholarly journals Pseudoaneurysm of the internal iliac artery caused by proximal femoral nail antirotation following intertrochanteric fracture: a case report

2019 ◽  
pp. 030006051989238
Author(s):  
Cheng Ren ◽  
Qian Wang ◽  
Teng Ma ◽  
Zhong Li ◽  
Huijun Yuan ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Intertrochanteric Fracture ◽  
Internal Iliac Artery ◽  
Rare Complication ◽  
Proximal Femoral Nail ◽  
Intense Pain ◽  
Left Femur ◽  
Femoral Nail ◽  
Internal Iliac ◽  
Proximal Femoral Nail Antirotation

Pseudoaneurysm of the internal iliac artery is a very rare complication of intertrochanteric fracture. Here, the case of an 88-year-old female patient, who presented with intense pain following surgery for intertrochanteric fracture of the femur, is reported. Radiography revealed intertrochanteric fracture of the left femur fixed by proximal femoral nail antirotation (PFNA). The PFNA was found to have disassembled, and the screw had penetrated through the acetabulum. As computed tomography (CT) revealed a haematoma behind the acetabulum, CT angiography was immediately performed. A pseudoaneurysm of the internal iliac artery caused by PFNA was revealed. Percutaneous endovascular treatment of the pseudoaneurysm was undertaken on an urgent basis. Three days later, the PFNA was removed, and the fracture was reduced and fixed with locking proximal femoral plate. The patient’s pain was significantly reduced following this corrective surgery. This case illustrates that substandard PFNA surgery for intertrochanteric fracture may result in pseudoaneurysm of the internal iliac artery.

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