Cutout of proximal femoral nail antirotation resulting from blocking of the gliding mechanism during fracture collapse.

The proximal femoral nail antirotation had been successful in treating unstable trochanteric fractures. Previous studies have shown technical problems such as unsatisfactory fracture reduction, poor insertion technique, and poor blade position leading to complications such as cutout. We present a case of proximal femoral nail antirotation cutout resulting from the blocking of the gliding mechanism during fracture collapse by the lateral cortex. The trochanteric fracture had not healed on presentation and there was significant acetabulum protrusion of the device. Thus, a cemented total hip arthroplasty was required.