PMC6044857_01
After reduction of intertrochanteric fracture, a guide pin was inserted into tip of the trochanter.
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PMC6044857_01_sicotj-4-31-fig1_small.jpg
F1
We treated with satisfied close reduction with traction on a traction operating table, and then captured the best point to insert the guide needle (Figure 1).
The reamer head was broken, then ruptured completely finally, and remained in femoral shaft isolated, it can't pull out just rely on hauling.
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PMC6044857_01_sicotj-4-31-fig2_small.jpg
F2
What's the worst, the reamer head was ruptured completely finally, and remained in femoral shaft isolated (Figure 2).
A long strip bony window by using an osteotome, which is just right for inserting a bone detacher.
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PMC6044857_01_sicotj-4-31-fig3_small.jpg
F3
Therefore we performed an open technique and created a 2.0 cm x0.4 cm long strip bony window by using an osteotome, which is just right for inserting a bone detacher, then put the detacher head adjoin the reamer, we moved out the broken reamer head by knocking back the inserted detacher and pulling out through the medullary cavity using a Kocher's clamp (Figure 3).
The broken reamer was moved completely, and PFNA was implanted.
sicotj-4-31-fig4_small.jpg
PMC6044857_01_sicotj-4-31-fig4_small.jpg
F4
A set of PFNA was inserted to fixation and the bony window was full with bony bar taken down before, and the fracture got a good bone union after 2 months (Figure 4).