Total Hip Arthroplasty for Femoral Neck Fracture in the Setting of Challenging Extraction of an Intramedullary Femoral Nail: A Case Report

INTRODUCTION: Performing total hip arthroplasty (THA) for femoral neck fracture in the setting of a pre-existing intramedullary nail can be technically challenging, particularly if nail extraction is not feasible. CASE REPORT: A 76-year-old male presented with a with a displaced femoral neck fracture in the setting of a previously placed antegrade intramedullary nail with a healed femoral shaft fracture. After failed nail extraction, a novel technique was used to remove the proximal portion of the nail to allow for hybrid THA with implantation of a cemented femoral stem. CONCLUSION: This is the first reported surgical technique of using a cortical window technique for partial intramedullary nail resection and cemented stem implantation in the setting of challenging intramedullary femoral nail extraction.