title: Unusual mode of failure of intertrochanteric femur fracture fixation.
abstract: The dynamic hip screw fixation is a commonly used modality of treatment for intertrochanteric femur (ITF) fractures. Various modes of failure in an operated case of ITF fracture have been described. The most frequent mode of failure is screw cut-out through the head. Occurrence of mechanical failure is rare and usually involves the shaft of the plate. We describe an unusual case with failure at the barrel of the plate and hip screw. A middle-aged man with a previously operated ITF fracture presented with pain in the same hip. Radiographs revealed non-union of the fracture with an implant failure. Revision surgery was performed during which a unique mode of implant failure was found to have occurred. The barrel of the plate had broken resulting in a bent Richard's screw. This case underlines the importance of high stress failure in non-union as opposed to high cycle, low stress failure, which is more frequently seen.
authors.affiliation: Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Kunal
authors.initials: K
authors.lastname: Roy
authors.affiliation: Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Pradip
authors.initials: P
authors.lastname: Nemade
authors.affiliation: Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Nirmal
authors.initials: N
authors.lastname: Patil
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation; D016896:Treatment Outcome