SUMMARYDislocation of the trial femoral head is a rare and unpleasant event that can compromise the success of the total hip arthroplasty. A 62-year-old Caucasian woman with osteoarthritis was admitted to our Department and underwent an elective total hip arthroplasty. While performing the dislocation manoeuver the trial femoral head dissociated from the taper in the superior and anterior direction in the soft tissue and could not be retrieved immediately. The operation was then executed and finished in an ordinary manner. Three months after discharge from our department patient presented with the pain in the hip and groin and periprosthetic joint infection was diagnosed. The successful second operation for the retrieval of the dislocated trial femoral head was conducted through ilioinguinal approach. In this paper we reviewed the published literature and developed the algorithm for the decision-making while dealing with the dislocated and lost trial femoral head.
BACKGROUND
IntroductionThe removal of broken femoral stems has become a major issue in revision surgery, and is a technically difficult and time-consuming procedure.Case presentationWe present a case of a fracture of a cementless long femoral stem in a 65-year-old, white Caucasian man. The distal part was removed with a special longitudinal osteotomy through the anterior cortex extending distally for 10cm. It was then followed by a transversal osteotomy 2cm below the tip of the femoral stump to allow enough space for two locking pliers. Simultaneously using a lamina spreader on the distal part, the broken stem was extracted while hammering on two locking pliers.ConclusionsWe developed a simple and easy technique for the removal of a broken femoral stem that can be applied to all kinds of femoral stems and intramedullary nails regardless of their cross section. We used ordinary surgical instruments and spared the remaining bone stock.
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