Indigenous Proximal Femoral Nails and Their Novel Complications

Pertrochanteric fractures are one of the commonest fractures in the geriatric age group. Management of these fractures has been revolutionized by the use of proximal femoral nails (PFN), with a screw or a helical blade for fixation in the femoral head. Multiple complications like Z-effect, screw cut out, head penetration, varus collapse, and so on are known with poor technique in proximal femoral nails antirotation (PFNA). We present a case where an indigenous implant presented to us a novel problem of helical blade breakage inside the bone in situ. Removal of this blade needed an open approach, extending the surgical time as well as blood loss. This led to poorer outcomes and the intraoperative struggle for the surgeon. We feel that all surgeons, especially when using indigenous implants, should be aware of such complications and thoroughly check the helical blade and its collapsing mechanism before inserting this in the bone.