A treatment option for femoral neck fractures complicating hip arthrodesis: conversion to a constrained total hip replacement

Abstract

We describe a case of an intracapsular neck of femur fracture occurring below an arthrodesed hip. This is an unusual fracture. We propose a method of conversion of this fracture to a constrained cup arthroplasty based on our experience of failure of screw fixation. Hip arthrodesis remains an acceptable method of treatment in degenerative hip disease (Panagiotopoulos et al. in Instr Course Lect 50:297–305, 2001). It provides pain relief, enables an active lifestyle and reduces the need for multiple revision surgeries compared to total hip arthroplasty (Beaule et al. in J Am Acad Orthop Surg 10:249–258, 2002). Its prevalence in the management of TB coxarthritis before the advent of antituberculous treatment means a trauma surgeon should be aware of the possibility of this fracture in the ageing population.