Dislodgement of the locking cap from the AO unreamed intramedullary nail: a case report

We report on the dislodgement of the proximal locking cap from an AO solid femoral intramedullary nail with spiral blade. The pathologic femoral fracture subsequently went on to heal, and the spiral blade did not back out of the femoral neck. Meticulous intraoperative attention to detail is required to select the correct offset for the proximal cap, because the turning moments of the hip abductor muscles are sufficient to unscrew a prominent cap.