Complications in a Young Adult Attributable to a Retained Pediatric Dynamic Hip Screw

INTRODUCTION: Orthopedic implants are used for many different conditions in the pediatric population. The literature on hardware removal is controversial and vague. CASE REPORT: We highlight a young adult male who underwent a dynamic hip screw (DHS) due to a motor vehicle accident at 11 years old. He healed the fracture and did well for years. He was lost to follow-up and the hardware was never removed. The patient presented to our facility with a periprosthetic subtrochanteric proximal femur fracture just distal to the retained hardware. The DHS was removed and the fracture fixed with an intramedullary nail. The patient healed the fracture and did well. DISCUSSION: A literature review was performed to highlight the benefits and complications of hardware removal vs. retention. We hope to equip the orthopedic surgeon with the reasons for or against hardware removal to optimize treatment to each patient. In this instance, we recommend hardware removal due to the serious consequences of retained hardware in the adolescent/young adult population.