Management of Short Proximal Femur Nail Peri-Implant Fracture of Femur Shaft with Implant Removal and Long Distal Femur Locking Plate and Bone Grafting – A Case Report

INTRODUCTION: The rising demographic trend towards elderly population and increased incidence of osteosynthesis of proximal femur fractures are associated with increased recurrent falls and rise in incidence of peri- implant fractures. CASE REPORT: Here, we present a difficult case of a peri-implant femur shaft fracture in a 55-year-old male, with stuck short proximal femur nail (PFN) removal followed by long distal femur plating with bone grafting showing good fracture union at 1 year with satisfactory functional outcome. CONCLUSION: Peri- implant femur fractures are quite rare and more commonly occur in elderly. Among all treatment modalities for intertrochanteric femur fracture fixation, the literature shows short PFN having highest comparative risk for peri-implant fractures. Implant removal followed by locking plates for long spiral fractures provides a stable, anatomical, and reliable fixation. Bone grafting augments bony union, especially in cases of bone defects .