A Case Report of Unique Complications of PFNA Penetration of the Blade into the Hip Joint

Se-Ang Jang; Young-Ho Cho; Young-Soo Byun; Hun-Sik Cho; Sung Choi; Hyun-Seong Yoo

doi:10.5371/jkhs.2011.23.4.318

Journal List > J Korean Hip Soc > v.23(4) > 1048744

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jang, Cho, Byun, Cho, Choi, and Yoo: A Case Report of Unique Complications of PFNA Penetration of the Blade into the Hip Joint

Case Report

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(4): 318-322.

Published online: 31 December 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.4.318

A Case Report of Unique Complications of PFNA Penetration of the Blade into the Hip Joint

Se-Ang Jang, MD, Young-Ho Cho, MD, Young-Soo Byun, MD, Hun-Sik Cho, MD, Sung Choi, MD, Hyun-Seong Yoo, MD

Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

Address reprint request to Young-ho Cho, MD. Department of Orthopaedic Surgery, Daegu Fatima Hospital, 576-31 Sinam-dong, Dong-gu, Daegu, 701-600, Korea. TEL: +82-53-940-7320, FAX: +82-53-954-7417, femur1973@hanmail.net

Received 7 June 2011 Revised 5 December 2011 Accepted 6 December 2011

Abstract

The proximal femoral nail anti-rotation (PFNA) is a useful device to fix trochanteric fractures of the proximal femur. We report a case of postoperative penetration of the helical blade through the femoral head into the hip joint without any sign of rotational or varus instability in the fracture.

Keywords: Femur, Proximal fracture, PFNA, Penetration

Figures and Tables

Fig. 1

(A, B) Immediate postoperative right hip anteroposterior and lateral radiograph.

Fig. 2

(A, B) 1 year follow up radiograph shows penetration of blade into hip joint.

Fig. 3

(A, B) Radiograph taken 23 months after 2^nd operation shows completely united fractures and well maintained short blade in the femoral head.

References

1. Halder SC. The Gamma nail for peritrochanteric fractures. J Bone Joint Surg Br. 1992. 74:340–344.

2. Boldin C, Seibert FJ, Frankhauser F, Peicha G, Grechenig W, Szyszkowitz R. The Proximal femoral nail (PFN) - a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand. 2003. 74:53–58.

3. Chang SA, Cho YH, Byun YS, Han JH, Park JY, Lee CY. The treatment of trochanteric femoral fracture with using proximal femoral nail antirotation (PFNA). J Korean Hip Soc. 2009. 21:252–256.

4. Byun YS, Yoo CH, Nam JM, Cho YH, Shin DJ. Unstable trochanteric fractures of the femur treated with a condylar blade plate. J Korean Soc Fract. 2002. 15:320–327.

5. Sommers MB, Roth C, Hall H, et al. A laboratory model to evaluate cotout resistance of implants for pertrochanteric fracture fixation. J Orthop Trauma. 2004. 18:361–368.

6. Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM. The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am. 1995. 77:1058–1064.

7. Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961. 43-B:647–663.

8. Cleveland M, Bosworth DM, Thompson FR, Wilson HJ Jr, Ishizuka T. A ten-year analysis of intertrochanteric fractures of the femur. J Bone Joint Surg Am. 1959. 41-A:1399–1408.

9. Adams CI, Robinson CM, Court-Brown CM, Mcqueen MM. Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur. J Orthop Trauma. 2001. 15:394–400.

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

11. Butt MS, Krikler SJ, Nafie S, Ali MS. Comparison of dynamic hip screw and gamma nail: a prospective randomized controlled trial. Injury. 1995. 26:615–618.

12. Strauss E, Frank J, Lee J, Kummer FJ, Tejwani N. Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: a biomechanical evaluation. Injury. 2006. 37:984–989.

13. Brunner A, Jöckel JA, Babst R. The PFNA proximal femur nail in treatment of unstable proximal femur fractures--3 cases of postoperative perforation of the helical blade into the hip joint. J Orthop Trauma. 2008. 22:731–736.

TOOLS

Similar articles