Intravascular Contrast Leakage in Intertrochanteric Fragility Fracture

CASE: A 90-year-old woman with osteoporosis sustained a right intertrochanteric fracture and underwent closed reduction and internal fixation with a Proximal Femoral Nail Antirotation (PFNA). During preaugmentation assessment, radiopaque contrast injected through the PFNA blade-intended to exclude intra-articular communication-unexpectedly leaked into surrounding vasculature, indicating potential intravascular access. Cement injection was aborted, and the patient recovered uneventfully under a multidisciplinary fragility fracture care pathway. CONCLUSION: This is the reported case of intravascular contrast leakage during preaugmentation assessment in hip fixation, highlighting the importance of routine contrast injection to identify vascular communication and prevent possible cement embolism.