Revision of a blade cut-out in PFN-A fixation: Blade exchange, cement augmentation and a cement plug as a successful salvage option.

Hanke, M.S.; Beckmann, N.A.; Keel, M.J.B.; Siebenrock, K.A.; Bastian, J.D. (2020). Revision of a blade cut-out in PFN-A fixation: Blade exchange, cement augmentation and a cement plug as a successful salvage option. Trauma case reports, 27(100303), p. 100303. Elsevier 10.1016/j.tcr.2020.100303

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A potential and feared complication of proximal femur nails with cephalomedullary fixation is migration of the cephalomedullary screw or blade (cut-out or cut-through). In patients not suitable (e.g. low demand, comorbidities) for conversion to total hip arthroplasty blade exchange with cement augmentation may be an option. This article describes the first successful clinical use of a salvage procedure of a previously published technique, which allows the surgeon to avoid intraarticular cement leakage by using a standard cement plug to close the defect in the femoral head.

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