Systematic review, Level IV.

No abstract

Pertrochanteric femoral fractures are routinely treated with cephalomedullary nailing, with good success. In the event of nonunion, implant fatigue failure may occur. The Trigen InterTAN system (Smith & Nephew, Memphis, TN) features 2 integrated ceph-alomedullary screws for improved rotational stability of the proximal segment. The inferior compression screw prevents rotation of the larger, superior lag screw. In the event of inferior screw breakage, the retained portion will prevent the integrated lag screw from being rotated to permit extraction. We present a case of a broken nail as well as a broken integrated screw, and describe a technique for successful implant removal.