Fig. 1
(A) Radiograph of left hip anteroposterior (AP) and lateral shows a femoral trochanteric fracture AO/OTA type 31A2.2. (B, C) C-arm image intensifier AP image shows that the intertrochanteric fracture was reduced extramedullary with an anatomical position, and the lateral image shows central axial alignment with neutral reduction.

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Fig. 2
(A) Helical blade is suspected of being located at the borderline of Cleveland index 5 and 6, and tip apex distance (TAD: distance between femoral head cortex and the tip of the helical blade) is 11 mm in anteroposterior (AP) and 18 mm in lateral postoperative simple radiograph. In AP radiograph, achieved extramedullary reduction with the anatomical position. The lateral radiograph shows an intramedullary reduction state with posterior angulation of central axial alignment. (B) Four weeks after surgery, no difference in the reduction state and TAD of the helical blade was observed in the follow-up simple radiograph. (C) Ten weeks after surgery, the helical blade was loosened in the follow-up simple radiograph but was neglected. (D) Sixteen weeks after surgery, the helical blade loosening was increased compared to the previous simple radiograph.

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Fig. 3
(A) In the simple radiograph, the distal sleeve of the helical blade was dissembled from the blade. The anteroposterior radiograph shows a varus change in the fracture compared to the previous simple radiograph, reduction state in the lateral view showed shortening, and a proximal fragment was displaced into intramedullary. (B) Simple radiograph shows non-cemented type bipolar hemiarthroplasty of the left hip. (C) Twelve months after bipolar hemiarthroplasty. The last follow-up radiograph shows no significant change after full weight ambulation with a cane compared to the previous radiograph.

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