Proximal femoral nail anti-rotation (PFNA) is a routine method to deal with intertrochanteric fractures in the elder population. It is challenging to remove PFNA in some cases as a result of stripping of blade heads. In this case presentation, we describe a novel technique using commonly available instruments that can be used to remove stripped, even broken anti-rotation blade where conventional methods have failed. The subject underwent a PFNA removal surgery 15 months after the previous fixation. We encountered difficulties using the regular instrument to remove the anti-rotation blade. A 5-mm tungsten carbide bur was used to drill a single cortical hole at the end of the blade. Then double-strand steel wire was threaded through the hole, and the distal part was shaped into a circle which could tie to the extraction screw. Slide Hammer was applied to gently knock out the blade along the anatomical direction of the femoral neck. The technique helped us successfully remove the anti-rotation blade and provided the patient with a satisfactory result. The use of a tungsten reamer and steel wire loop to remove the proximal femoral anti-rotation blade may provide a cost-effective and straightforward method of dealing with extraction failure.

中文翻译：

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一种在解锁失败后提取近端股骨钉抗旋转（PFNA）的简洁技术：一个病例报告。

股骨近端钉防旋转术（PFNA）是处理老年人口股骨转子间骨折的常规方法。在某些情况下，由于刀片头剥落而去除PFNA具有挑战性。在这种情况下，我们介绍了一种使用常用仪器的新技术，该仪器可用于去除传统方法失败的剥离甚至破碎的防旋转刀片。该对象在先前的固定后15个月接受了PFNA切除手术。我们在使用常规仪器卸下防旋转刀片时遇到了困难。使用5毫米的碳化钨钻针在刀片末端钻一个皮质孔。然后，将双股钢丝穿过该孔，并将其远端部分成形为一个圆形，该圆形可以与拔出螺钉连接。施加滑锤以沿股骨颈的解剖学方向轻轻敲除刀片。该技术帮助我们成功移除了防旋转刀片，并为患者提供了满意的结果。使用钨扩孔钻和钢丝环来去除股骨近端防旋转刀片可提供一种经济有效的直接方法来处理拔除失败。