# Treatment of Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Severely Osteoporotic Patient With a Revision Stem

## TL;DR

This case report discusses a failed PFNA2 implant in a 74-year-old osteoporotic patient and the subsequent treatment with bipolar hemiarthroplasty.

## Contribution

The paper presents a clinical case emphasizing the importance of surgical skill and implant choice in managing osteoporotic hip fractures.

## Key findings

- A failed PFNA2 implant in a 74-year-old osteoporotic patient was treated with bipolar hemiarthroplasty.
- High reduction quality and blade alignment are critical to prevent mechanical failure in osteoporotic hip fractures.
- Revision with joint replacement may be necessary when internal fixation fails in osteoporotic patients.

## Abstract

An intertrochanteric fracture is a prevalent and perilous kind of fracture that often affects older persons. A customized implant, proximal femoral nail anti-rotation Asia (PFNA2) is being used expressly in unstable intertrochanteric fractures in people with osteoporosis. In this case report, we examined a female osteoporosis patient, age 74, who underwent a failed PFNA2 procedure. Subsequently, the patient had bipolar hemiarthroplasty as a treatment. To prevent mechanical failure, it is crucial to strive for a high level of reduction quality and precise alignment of the central blade throughout hip X-ray procedures. Improved surgical proficiency and skill are crucial for managing patients with severe osteoporosis and prolonged weight-bearing requirements, hence reducing the occurrence of postoperative problems. Depending on the cause of the failure and the individual circumstances of the patient when internal fixation fails, it is recommended to either replace the joint with a prosthetic or reapply fixation. These interventions may facilitate the production of beneficial healing outcomes.