ABSTRACT
The proximal femoral nail antirotation had been successful in treating unstable trochanteric fractures. Previous studies have shown technical problems such as unsatisfactory fracture reduction, poor insertion technique, and poor blade position leading to complications such as cutout. We present a case of proximal femoral nail antirotation cutout resulting from the blocking of the gliding mechanism during fracture collapse by the lateral cortex. The trochanteric fracture had not healed on presentation and there was significant acetabulum protrusion of the device. Thus, a cemented total hip arthroplasty was required.
Subject(s)
Bone Nails/adverse effects , Femoral Fractures/etiology , Femoral Fractures/surgery , Prosthesis Failure , Aged, 80 and over , Humans , MaleABSTRACT
We performed a prospective randomised trial to evaluate the efficacy of pre-operative skin traction for proximal femoral fractures in 311 patients. We found a significant difference in pain score on the evening of admission and the first morning after admission between the groups with traction compared the group without. However, there was no corresponding increase in analgesic requirement during this period. The peak pain score pattern also was different in our population. No other objective benefit can be shown from using skin traction, and its routine use should be abandoned.