Incredible position of broken sliding dynamic hip screw implant in the medial of thigh

We report a case with implant failure after nailing of an unstable pertrochanteric fracture with dynamichip screw. The patient presented with a medial sided thigh pain at 5 years after the surgery. Plain radiographs showed nonunion of the fracture with distant migration of assembled hip screw and side plateto the subcutaneous area of the inner thigh.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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1. Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB. The incidence rate of hip fracture in Shiraz, Iran during 2008-2010. Arch Osteoporos. 2014;9:165. http://dx.doi.org/10.1007/s11657-013-0165-9.

2. Kazemian GH, Manafi AR, Najafi F, Najafi MA. Treatment of intertrochanteric fractures in elderly highrisk patients: dynamic hip screw vs. external fixation. Injury. 2014;45:568e572.

3. Spivak JM, Zuckerman JD, Kummer FJ, Frankel VH. Fatigue failure of the sliding screw in hip fracture fixation: a report of three cases. J Orthop Trauma. 1991;5:325e331.

4. Arastu MH, Phillips L, Duffy P. An unusual failure of a sliding hip screw in the immediate post-operative period. Inj Extra. 2013;44:23e27.

5. Khanna A, Khanna A, Parker M. Rare mode of dynamic hip screw failure. Hip Int. 2008;18:239e241.

6. Roy K, Nemade P, Aggarwal R, Patil N. Unusual mode of failure of intertrochanteric femur fracture fixation. BMJ Case Rep. 2015 Nov 12;2015. http://dx.doi.org/ 10.1136/bcr-2015-213012. pii: bcr2015213012.

7. Hsueh KK, Fang CK, Chen CM, Su YP, Wu HF, Chiu FY. Risk factors in cutout of sliding hip screw in intertrochanteric fractures: an evaluation of 937 patients. Int Orthop. 2010;34:1273e1276.

8. De Bruijn K, den Hartog D, Tuinebreijer W, Roukema G. Reliability of predictors for screw cutout in intertrochanteric hip fractures. J Bone Jt Surg Am. 2012;94: 1266e1272.

9. Müller MA, Hengg C, Krettek C, et al. Trabecular bone strength is not an independent predictive factor for dynamic hip screw migrationeA prospective multicenter cohort study. J Orthop Res. 2015;33:1680e1686.

10. Hrubina M, Skotak M, Krumpl O, Míka P, Letocha J. Osteosynthetic material breakage in patients treated with DHS for proximal femoral fracture. Rozhl Chir. 2012;91:146e150.

11. Jakobsen BW. Breakage of a sliding hip screw. A case report. Acta Orthop Scand. 1987;58:292e293.