Primary total hip arthroplasty with a retained intramedullary femoral nail

Retained intramedullary femoral nails can pose a problem for the implantation of the femoral component during total hip arthoplasty (THA) and they must often be removed. A patient with a retained Küntscher femoral nail implanted 47 years previously presented in our outpatient clinic for a THA. Since removal of the nail was impossible without severe damage to the femur, we chose to perform an extended trochanteric osteotomy, to cut the proximal part of the nail and to implant a cemented short stem with its tip in the hollow end of the nail.