A rare complication of pelvic perforation by an excessive medial slide of the helical blade after treatment of an intertrochanteric fracture with proximal femoral nail anti-rotation:A case report and literature review  

作　　者：Xiao-Kun Chen Jian Xiong Yi-Jun Liu Quan Han Tian-Bing Wang Dian-Ying Zhang 

机构地区：[1]Department of Orthopaedics and Trauma,Peking University People's Hospital,Beijing,100044,China [2]Trauma Center,National Center for Trauma Medicine,Key Laboratory of Trauma and Neural Regeneration,Peking University People's Hospital,Beijing,100044,China

出　　处：《Chinese Journal of Traumatology》2022年第2期118-121,共4页中华创伤杂志（英文版）

基　　金：National Key R&D Program of China,2018YFF0301103,The funding body will support the publication fees without affecting the diagnosis and treatment of the patient and the writing of the manuscript.

摘　　要：Intertrochanteric fractures have become a severe public health problem in elderly patients.Proximal femoral nail anti-rotation(PFNA)is a commonly used intramedullary fixation device for unstable intertrochanteric fractures.Pelvic perforation by cephalic screw is a rare complication.We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture.The patient underwent surgery with PFNA as the intramedullary fixation device.Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation.We performed a cemented total hip arthroplasty as the savage procedure.At the latest follow-up of 12 months after total hip arthroplasty,the patient had no pain or loosening of the prosthesis in the left hip.Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device,especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation.The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.

关 键 词：Hip fractures Intertrochanteric fractures Proximal femoral nail anti-rotation COMPLICATION Pelvic perforation Case report 

分 类 号：R68[医药卫生—骨科学]