Femoral Neck Fracture Following Hardware Removal
It is uncommon for femoral neck fractures to occur after proximal femoral hardware removal because age, osteoporosis, and technical error are often noted as the causes for this type of fracture. However, excessive alcohol consumption and failure to comply with protected weight bearing for 6 weeks increases the risk of femoral neck fractures.
This article describes a case of a 57-year-old man with a high-energy ipsilateral inter-trochanteric hip fracture, comminuted distal third femoral shaft fracture, and displaced lateral tibial plateau fracture. Cephalomedullary fixation was used to fix the ipsilateral femur fractures after medical stabilization and evaluation of the patient. The patient healed clinically and radiographically at 6 months. Despite conservative treatment for painful proximal hardware, elective hip screw removal was performed 22.5 months after injury. Seven weeks later, he sustained a nontraumatic femoral neck fracture.
In this case, it is unlikely that the femoral neck fracture occurred as a result of hardware removal. We assumed that, in addition to the patient’s alcohol abuse and tobacco use, stress fractures may have attributed to the femoral neck fracture. We recommend using a shorter hip screw to minimize hardware prominence or possibly off-label use of an injectable bone filler, such as calcium phosphate cement.
- Hip Pain: What Do Your Symptoms Mean? (everydayhealth.com)
- A Guide to Hip Anatomy (everydayhealth.com)
- How One Might Determine Whether The Femur Fracture Is Related To A Bisphosphonate Such As Fosamax (drug-injury.com)
- Study Identifies Fractures Most and Least Likely to Be Caused by Osteoporosis (ahrq.gov)
- Total Hip Replacement – Short Review (earlsview.com)
- Total hip replacement for high dislocated hips without femoral shortening osteotomy: (earlsview.com)
- Could You Have a Fractured Bone? (everydayhealth.com)
- Benefits of Osteoporosis Treatments Outweigh Possible Risk of Rare Femoral Fractures (prweb.com)