Sunil Gurpur Kini,Lai Choon Hin,Jikku Haniball.[J].Chin J Traumatol,2015,18(2):116-119. [doi]
Lateral cortex blowout during PFNA blade insertion in a subtrochanteric fracture-Should bone quality determine the type of nail used?
  
DOI：
KeyWord: Subtrochanteric fractures  Proximal femoral nail antirotation  Sclerotic bone
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Author NameAffiliation
Sunil Gurpur Kini Department of Orthopaedics, University College London Hospitals, London, United Kingdom 
Lai Choon Hin Department of Orthopaedics, Tan Tock Seng Hospital, Singapore 
Jikku Haniball Department of Orthopaedics, Tan Tock Seng Hospital, Singapore 
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Abstract:
      Subtrochanteric fractures pose a therapeutic challenge to the surgeons. With the advent of proximal femoral nails, most of the cases are treated with nailing. Newer nails like proximal femoral nail antirotation (PFNA) require the blade to be directly hammered into the bone compared to older nails where the screws are drilled and tapped before insertion. We report one such case in a middle aged female that had intraoperative lateral cortex blowout during PFNA blade insertion in a sclerotic bone. This occurrence to the best of our knowledge is unreported in literature. It is therefore imperative to consider the quality of bone before a decision is made on the implant chosen.
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