Conversion of cephalomedullary nail fixation to hip arthroplasty: technical points and pitfalls

Cephalomedullary nail fixation is used to treat proximal femur fractures. Some of these internal fixation constructs fail secondary to hardware failure, fracture malunion or nonunion, or the interval development of degenerative arthritis. Converting one of these constructs to a hip arthroplasty is technically more demanding and has a higher complication rate compared with routine primary total hip replacement. In this article, we review tips, techniques, and potential pitfalls for converting cephalomedullary nail fixation to hip arthroplasty-knowledge that orthopedic surgeons can use to minimize intraoperative and postoperative complications.