Mismatch between PFNa and medullary canal causing difficulty in nailing of the pertrochanteric fractures.

The proximal femoral nail (PFN) and the proximal femoral nail anti-rotation (PFNA) have been successfully used in the management of osteoporotic pertrochanteric fractures. Although many studies have described the geometrical mismatch between the antecurvation of the femur and the contemporary intramedullay nails, technical difficulties related to the mismatch between the femoral bowing and the PFN/PFNA at the time of nailing have rarely been discussed in the literature. We have experienced a technical difficulty related to the mismatch between the medullary canal and the PFN/PFNA. We describe the complications related with the mismatch and the technical pitfalls and some technical tips to avoid this problem are also described.