Lateral Cortical Notching in Revision of a Subtrochanteric Fracture Non-union with Breakage of a Cephalomedullary Nail.

INTRODUCTION

Trochanteric fractures are common in elderly patients. Subtrochanteric fracture patterns are challenging due to the risk for non-union.

CASE REPORT

We report a case of an 87-year-old woman with a subtrochanteric fracture treated with a cephalomedullary nail. A cutout of the blade occurred in the early follow-up and was treated with exchange nailing elsewhere. Late nail breakage due to non-union more than 4 years after exchange nailing was noted. The fracture healed uneventfully after revision at our institution with exchange nailing including the lateral cortical notching technique whilst applying osteoinductive supplements.

CONCLUSION

From our point of view, the concept of lateral cortical notching should be taken into consideration to enhance treatment of subtrochanteric non-unions by exchange nailing.