This complication usually happen when
the registrar or the resident made multiple holes by the K.wire in the lat. cortex trying
to localize the center of the neck.
The problem of these fractures it extends above the lesser trochanter , If you can put DHS
this will be excellent but the entry of the DHS will be below or at the fracture
site and this is difficult to hold the fracture very well.
I would suggest to leave the screw in place and put Buttress T-plate after reduction of
the fracture with 3 screws above the fracture and 4-5 below ,followed by NWB
for 6 weeks.
The risk of AVN is possible.
I Did find in my collections one similar case of yours.
Best Luck.
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Dr.Freih Odeh Abu Hassan,
M.D.(Orth.) ,F.R.C.S.(Eng.) ,F.R.C.S.(Tr.&Orth.).
Asst.Prof. of Orthopedics & Pediatric Orthopedics Surgery,
University of Jordan - Amman.