Use of calcium phosphate cement after removal of a cephalomedullary nail: A case report

Femoral neck fracture in the absence of trauma is a rare, but known complication after hardware removal. This complication may be due to the boney defect created by the hardware removal itself, or the increase in femoral neck strain that occurs after removal of the hardware. Previous biomechanical studies have suggested that filling the defect with calcium phosphate cement after removal of hardware may prevent the development of a femoral neck fracture. However, there are no reports on the use of calcium phosphate cement after removal of hardware in the clinical setting. The purpose of this case discussion is to present the first reported case, to our knowledge, of the use of calcium phosphate cement augmentation of the boney defect after lag screw removal, and the subsequent failure resulting in atraumatic femoral neck fracture.