BREAKAGE OF A ZNN NAIL IN AN ACTIVE ELDERLY FEMALE: A CASE REPORT AND LITERATURE REVIEW

Trochanteric fractures are common in elderly patients with osteoporosis and are surgically treated to facilitate early rehabilitation and to prevent lodging-related comorbidities. Nonunion and hardware breakage of intertrochanteric hip fractures is a relatively rare occurrence resulting from an incorrect surgical procedure. We present a case of ZNN nail breakage caused by fatigue of an unstable trochanteric fracture in a very active elderly female.An 84 year-old woman was treated with a long pertrochanteric femoral nail. Six months after surgery, she returned to the emergency department due to the ruptured nail. The patient underwent hemiarthroplasty with a stem revision and, after removing the nail, was stabilized with a trochanteric gripping plate and rims.Long-term results assessed with the Harris Hip Score and the Oxford Hip Score were excellent. The patient's quality of life improved greatly. Our experience confirms that total hip hem arthroplasty is a satisfactory revision procedure after failed treatment of an intertrochanteric fracture in elderly patients with poor bone stock and high functional demands in daily activities.