Breaking the Bond, Overcoming Cold Welding in Femoral Neck System During Conversion Total Hip Arthroplasty

Case: The femoral neck system (FNS) offers angular stability for femoral neck fractures but poses challenges during conversion total hip arthroplasty (THA) due to cold welding, which occurs in up to 28% of cases, increasing operative time and bone loss. This case report of a 25-year-old man who developed AVN after a femoral neck fracture treated with the FNS illustrates a systematic approach for implant removal in the setting of cold welding, using high-speed burring to transect the plate and extract the screw-plate unit intact. Conclusion: Understanding cold welding mechanisms and using advanced removal techniques optimizes outcomes following conversion THA after FNS.