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To prevent the unintentional increase of the posterior tibial slope, special attention should be paid to locate the intact cortical hinge on the lateral, not the posterolateral, side of the tibia.

Measurement of ST on radiographs is a simple and reliable method to track changes in pelvic tilt in different body positions. There is significant intersubject and intrasubject variation of ST and MAT with postural changes and it may explain causes of impingement or instability following THA, which could not be previously explained.

The proximal femoral nail (PFN) and the proximal femoral nail anti-rotation (PFNA) have been successfully used in the management of osteoporotic pertrochanteric fractures. Although many studies have described the geometrical mismatch between the antecurvation of the femur and the contemporary intramedullay nails, technical difficulties related to the mismatch between the femoral bowing and the PFN/PFNA at the time of nailing have rarely been discussed in the literature. We have experienced a technical difficulty related to the mismatch between the medullary canal and the PFN/PFNA. We describe the complications related with the mismatch and the technical pitfalls and some technical tips to avoid this problem are also described.

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