Presentation
Sustained a pertrochanteric fracture a month earlier. Increasing hip pain over the past few weeks.
Patient Data
Age: 80 years
Gender: Female
From the case:
Gamma nail fixation - sliding screw cut-out complication
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The neck-shaft angle has collapsed into varus, with resultant off-center femoral neck screw extruding into the pelvis.
From the case:
Gamma nail fixation - sliding screw cut-out complication
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The gamma nail fixation was removed, and a total hip arthroplasty was performed.
Case Discussion
Intramedullary fixation is the preferred first-line treatment for trochanteric fractures, however it may fail in case of unstable fractures, in which case arthroplasty is the standard approach. Of note, the most common mechanical failure is sliding screw cut-out through the femoral head 2.
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