An Effective Femoral Head Extraction Technique in Hip Arthroplasty for Femoral Neck Fractures

Background: Removal of the fractured femoral head during hip arthroplasty for displaced subcapital femoral neck fractures can be technically challenging. Traditional axial corkscrew placement through the fractured neck often suffers from poor purchase in osteoporotic bone or may fail due to the distal femur obstructing the extraction path, leading to increased operative time and potential for soft tissue trauma. Technique: A reproducible technique for efficient femoral head extraction is intraduced via placement of a corkscrew is into the superior bone stock at the posterior head-neck junction. The ipsilateral lower extremity is then manipulated via flexion and internal rotation to clear the extraction path, allowing the head to be easily extracted. Conclusion: Placing the corkscrew at the posterior head-neck junction combined with coordinated leg manipulation offers a highly efficient, reliable, and low-risk method for femoral head extraction that minimizes operating time, preserves surrounding soft tissue, and avoids possible pitfalls of axial levering.