Journal List > J Korean Fract Soc > v.26(2) > 1037923

J Korean Fract Soc. 2013 Apr;26(2):151-155. Korean.
Published online April 22, 2013.
Copyright © 2013 The Korean Fracture Society
Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -
Bong-Ju Park, M.D., Hong-Man Cho, M.D., Ju-Han Kim, M.D. and Woo-Jin Sin, M.D.
Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.

Address reprint requests to: Hong-Man Cho, M.D. Department of Orthopedic Surgery, Gwangju Veterans Hospital, 91 Sanwol-ro, Gwangsan-gu, Gwangju 506-705, Korea. Tel: 82-62-602-6162, Fax: 82-62-602-6164, Email:
Received December 06, 2012; Revised February 05, 2013; Accepted February 05, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.

Keywords: Femur; Proximal fracture; Proximal femoral nail anti-rotation (PFNA); Sliding


Fig. 1
An 83-year-old male with right hip pain.

(A) Preoperative radiology showed AO/OTA type A2.2 intertrochanteric fracture.

(B) Preoperative 3-dimensional computerized tomography showed AO/OTA type A2.2 intertrochanteric fracture.

(C) Immediate postoperative radiology showed fixation with proximal femoral nail anti-rotation.

(D) Radiologic finding on his postoperative 16 weeks showed slight sliding of the helical blade.

Click for larger image

Fig. 2
(A) Anteroposterior radiograph taken 20 weeks after the operation showing back-out of the helical blade and femur neck fracture.

(B) Bipolar hemiarthroplasty was done.

Click for larger image

Fig. 3
(A) The retrieved femoral head showing subcapital femur neck fracture.

(B) Biopsy finding was normal mature trabecular bone and marrow fat tissue (H&E, ×40).

Click for larger image

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