Disengagement and intrapelvic migration of a dynamic helical hip screw

Some proximal femur fractures may be treated surgically with the use of fracture fixation hardware such as the sliding hip screw and its variants. These devices allow the femoral head and neck fragment to compress against the trochanteric or shaft fragment as the hip screw telescopes into the barrel of the side plate. We describe an unusual complication in which the hip screw disengaged in the opposite direction, migrated through the hip joint, and came to rest inside the pelvic cavity. The separated components of the device were surgically removed without further complication.