Central protrusion, or “cut-through” of the helical blade in proximal femoral nail antirotation (PFNA), is a unique and novel complication. Cases reported in the literature were presented early in the postoperative period and were associated with no bone healing, and managed with either revision or total hip replacement. We reported a case that presented late in the postoperative period that showed some bone healing and was erroneously treated with removal of the implant, resulting in varus malunion after implant removal. Possible causes for late presentation, preventive measures, and the need for early surgical intervention are discussed.
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