Introduction The removal of well-fixed broken femoral component and cement mantle can be extremely demanding, time consuming and potentially damaging to the host bone. Different methods have been described to extract broken femoral stem yet this remains one of the most challenging prospect to the revision hip surgeon. Presentation of cases: The authors present two cases underwent a modified sliding cortical window technique utilizing a tungsten carbide drill, Charnley pin retractor and an orthopaedic mallet to aid extraction of a fractured cemented femoral stem in revision total hip arthroplasty. Discussion The modified technique offers a simple and controlled method in extracting a well fixed fractured cemented femoral stem. It has the advantage of retaining the cement mantle with subsequent good seal of the femoral cortical window secured with cable ready system. Furthermore, tungsten carbide drill bit and Charnley pin retractor are relatively readily available to aid the extraction of the broken stem. Finally, it yields the option of implanting a standard femoral stem and obviates the need for bypassing the cortical window with long revision femoral component. Conclusions Fractured femoral stem is a rare yet a complex and very demanding prospect to both patients and hip surgeons. The sliding cortical window technique utilizing tungsten carbide drill and Charnley pin retractor is technically easy and most importantly; preserves host bone stock with cement-in-cement revision hip arthroplasty. We believe this technique can be added to the armamentarium of revision hip surgeon when faced with the challenge of extracting a fracture cemented femoral stem.
A modified technique to extract fractured femoral stem in revision total hip arthroplasty: A report of two cases
About the Author: Merzesh Magra
Mr Merzesh Magra is an experienced Consultant Orthopaedic Surgeon based in Lancaster specialising in hip and knee joint replacement surgery. He has 22 years of experience and is a results-oriented skilled surgeon and an ardent advocator of enhanced recovery principles.