Abstract
There are few reports on rotational deformity of the femoral head neck fragment after treatment with Proximal Femoral Nail (PFN). This report describes a rare case which showed rotational deformity of the head-neck fragment after treatment with PFN.
An 84-year-old woman sustained displaced left trochanteric fracture during a fall, which was classified as 32-A1-2 according to AO classification. The grade of osteoporosis of contralateral femur was grade 3 in Singh's classification. She was treated with PFN 8 days after injury. A hip pin was inserted to the level of great trochanter, which was not fixed rigidly enough. One day after the operation, she started standing training with full weight bearing. One week later, it was observed that she had a rotational deformity of the head-neck fragment, and weight-bearing standing training was stopped for 4 weeks to prevent progression of rotational deformity. No progression was observed even after full weight bearing walking after 10 weeks postoperatively. This case suggested rotational deformity in patients treated with PFN with severe osteoporosis may be prevented by deeper placement of the hip pin to the subchondral bone, which may prevent persistent rotational instability of the head-neck fragment.
