Healing Against the Odds: Successful Bone Union in Intertrochanteric Femur Fracture Despite Z-Effect and Implant Failure.

INTRODUCTION

Intertrochanteric femur fractures are common in the elderly, often resulting from low-energy trauma such as falls. Standard treatment typically involves internal fixation, which generally leads to good outcomes. However, complications like the Z-effect, where proximal screws of an intramedullary nail migrate in opposite directions, and implant failure can significantly impact healing.

CASE REPORT: A 58-year-old male patient sustained an intertrochanteric femur fracture following a fall. The fracture was treated with an intramedullary nail. Postoperatively, the patient developed the Z-effect, characterized by the migration of proximal screws in opposite directions. Subsequently, the implant failed, resulting in a broken nail and screw. Despite these complications, radiographic evaluations over time revealed progressive healing, and the patient eventually achieved complete bony union.

CONCLUSION

This case underscores the potential for successful bone healing even in the presence of significant complications such as the Z-effect and implant failure. The patient's complete bony union despite these challenges emphasizes the importance of diligent follow-up and adaptive management strategies in orthopedic practice. This case contributes to the understanding of fracture healing dynamics and highlights the resilience of bone healing mechanisms.