RESEARCH ARTICLE


A Complication During Femoral Broaching in Total Hip Arthroplasty: A Case Report



Wenzel Waldstein, Friedrich Boettner*
Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, Weill Medical College of Cornell University, USA


© Waldstein and Boettner; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA; Tel: 212.774.2127; Fax: 212.774.2286; E-mail: boettnerf@hss.edu


Abstract

Press-fit component fixation is one of the primary goals in uncemented total hip arthroplasty. When aiming at proximal load transfer, the stem size has to be selected with regard to the shape of the proximal femoral canal. This can be challenging in patients with ‘champagne flute’ femurs with a relatively narrow diaphysis, especially when a long stem femoral component is used. The present case report describes a complication during femoral broaching for a primary uncemented femoral component. Because of the narrow diaphysis, the distal portion of the broach got caught in the narrow canal and it became impossible to remove the broach with conventional techniques. Via a second distal incision, the femur was split from the distal tip of the broach to approximately 5 cm distal of the femoral neck cut along the posterior aspects of the femur. This loosened the broach enough to allow for an uncomplicated removal. The longitudinal split was secured with cables before a similar size primary implant was press fitted into the femoral canal.

Keywords: : Broaching, Canal Shape, Complication, Uncemented Femoral Component..