Treatment of Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Severely Osteoporotic Patient With a Revision Stem

Cureus. 2024 Feb 28;16(2):e55152. doi: 10.7759/cureus.55152. eCollection 2024 Feb.

Abstract

An intertrochanteric fracture is a prevalent and perilous kind of fracture that often affects older persons. A customized implant, proximal femoral nail anti-rotation Asia (PFNA2) is being used expressly in unstable intertrochanteric fractures in people with osteoporosis. In this case report, we examined a female osteoporosis patient, age 74, who underwent a failed PFNA2 procedure. Subsequently, the patient had bipolar hemiarthroplasty as a treatment. To prevent mechanical failure, it is crucial to strive for a high level of reduction quality and precise alignment of the central blade throughout hip X-ray procedures. Improved surgical proficiency and skill are crucial for managing patients with severe osteoporosis and prolonged weight-bearing requirements, hence reducing the occurrence of postoperative problems. Depending on the cause of the failure and the individual circumstances of the patient when internal fixation fails, it is recommended to either replace the joint with a prosthetic or reapply fixation. These interventions may facilitate the production of beneficial healing outcomes.

Keywords: bipolar hemiarthroplasty; internal fixation; intertrochanteric fracture; osteoporosis; proximal femoral nail antirotation.

Publication types

  • Case Reports