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Updated: Jul 1, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Mismatch between PFNa and medullary canal causing difficulty in nailing of the pertrochanteric fractures
Jin Ho Hwang1, Jong Keon Oh, Sang Hwan Han
1Department of Orthopaedic Surgery, Korea University School of Medicine, Guro Hospital, 80 Guro 2-dong, Guro-gu, Seoul 152-703, South Korea.
Abstract:
The proximal femoral nail (PFN) and the proximal femoral nail anti-rotation (PFNA) have been successfully used in the management of osteoporotic pertrochanteric fractures. Although many studies have described the geometrical mismatch between the antecurvation of the femur and the contemporary intramedullay nails, technical difficulties related to the mismatch between the femoral bowing and the PFN/PFNA at the time of nailing have rarely been discussed in the literature. We have experienced a technical difficulty related to the mismatch between the medullary canal and the PFN/PFNA. We describe the complications related with the mismatch and the technical pitfalls and some technical tips to avoid this problem are also described.
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