Gamma nail fixation - sliding screw cut-out complication

Case contributed by Dr Balint Botz

Presentation

Sustained a pertrochanteric fracture a month earlier. Increasing hip pain over the past few weeks.

Patient Data

Age: 80 years
Gender: Female

The neck-shaft angle has collapsed into varus, with resultant off-center femoral neck screw extruding into the pelvis.

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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Case information

rID: 61485
Published: 5th Jul 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included
Institution: University of Pécs

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