title: Complete traumatic backout of the blade of proximal femoral nail antirotation: a case report.
abstract: This article presents a rare case of traumatic complete expulsion of the helical blade after successful treatment of an intertrochanteric fracture with proximal femoral nail antirotation (PFNA). A 94-year-old woman sustained an intertrochanteric fracture of the left femur. Fracture fixation was performed by using PFNA-II. At six months FU, the patient presented with pain at the proximal lateral left thigh after she had fallen. A protrusion was noted. Radiographs showed a complete expulsion of the helical blade with a healed intertrochanteric fracture. The PFNA-II was removed and a cemented bipolar hemiarthroplasty was performed. At 5 months after surgery, the patient was able to walk with a walker without pain. Traumatic complete expulsion of the blade should be considered as a possible complication of PFNA/PFNA-II.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan. Electronic address: sangyang@beige.plala.or.jp.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Niikura
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Iwakura
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kuroda
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, 650-0017 Kobe, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001858:Bone Nails / Q000009:adverse effects*; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011859:Radiography; D012086:Reoperation
keywords: Complication; Fixation implant failure; Intertrochanteric fracture; PFNA; Proximal femoral nail antirotation