An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review
The proximal femoral nail antirotation (PFNA-II) is designed for fixation of unstable proximal femoral fractures in Asian patients due to its superior biomechanical properties. The helical blade achieves purchase through bone compaction and requires less removal of bone than a screw. Medial migratio...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-04-01
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| Series: | Trauma Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644019300123 |
| _version_ | 1819259021377404928 |
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| author | Mayur Nayak Rahul Yadav V. Ganesh Vijay Digge |
| author_facet | Mayur Nayak Rahul Yadav V. Ganesh Vijay Digge |
| author_sort | Mayur Nayak |
| collection | DOAJ |
| description | The proximal femoral nail antirotation (PFNA-II) is designed for fixation of unstable proximal femoral fractures in Asian patients due to its superior biomechanical properties. The helical blade achieves purchase through bone compaction and requires less removal of bone than a screw. Medial migration of the helical blade with perforation into the hip joint without loss of reduction is a rare problem noted with PFNA. Past literature reporting the migration of the helical blade medially, perforating the femoral head has been addressed as a characteristic complication of the PFNA. A review of literature suggests various reasons for the same such as fresh trauma, fracture settlement and failure of lateralization of the blade. We report a case of postoperative medial migration of the helical blade perforating the femoral head due to loosening of the locking bolt of the helical blade without any signs of rotational or varus displacement of the fracture. Keywords: Intertrochanteric fracture, Proximal femoral nail antirotation, Perforation, Migration, Loosening |
| first_indexed | 2024-12-23T19:03:23Z |
| format | Article |
| id | doaj.art-ff69fb747b4b4fd3b964db86c00f723e |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-12-23T19:03:23Z |
| publishDate | 2019-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-ff69fb747b4b4fd3b964db86c00f723e2022-12-21T17:34:39ZengElsevierTrauma Case Reports2352-64402019-04-0120An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature reviewMayur Nayak0Rahul Yadav1V. Ganesh2Vijay Digge3Jay Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India; Corresponding author at: All India Institute of Medical Sciences (AIIMS), Dept of Orthopaedics, Vth Floor, Teaching block, AIIMS Campus, New Delhi 110029, India.Jay Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaJay Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaThe proximal femoral nail antirotation (PFNA-II) is designed for fixation of unstable proximal femoral fractures in Asian patients due to its superior biomechanical properties. The helical blade achieves purchase through bone compaction and requires less removal of bone than a screw. Medial migration of the helical blade with perforation into the hip joint without loss of reduction is a rare problem noted with PFNA. Past literature reporting the migration of the helical blade medially, perforating the femoral head has been addressed as a characteristic complication of the PFNA. A review of literature suggests various reasons for the same such as fresh trauma, fracture settlement and failure of lateralization of the blade. We report a case of postoperative medial migration of the helical blade perforating the femoral head due to loosening of the locking bolt of the helical blade without any signs of rotational or varus displacement of the fracture. Keywords: Intertrochanteric fracture, Proximal femoral nail antirotation, Perforation, Migration, Looseninghttp://www.sciencedirect.com/science/article/pii/S2352644019300123 |
| spellingShingle | Mayur Nayak Rahul Yadav V. Ganesh Vijay Digge An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review Trauma Case Reports |
| title | An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review |
| title_full | An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review |
| title_fullStr | An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review |
| title_full_unstemmed | An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review |
| title_short | An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review |
| title_sort | unusual case of femoral head perforation following fixation with proximal femoral nail antirotation pfna ii for an unstable intertrochanteric fracture case report and literature review |
| url | http://www.sciencedirect.com/science/article/pii/S2352644019300123 |
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