A simple technique of removal of a stripped and incarcerated cannulated screw adjacent to the calcar in the femoral neck in a resource-limited setting: A case report

Abstract

Osteosynthesis of fracture neck of the femur with multiple cannulated screws is one of the standard techniques used, especially in non-elderly patients. Implant exit from the femoral neck is done in cases with hardware failure, infection, prominence, non-union, and pain among others. The femoral neck is unique due to its precarious blood supply, distribution of forces, and formation of dense trabeculae. The cannulated screw placed adjacent to the calcar region is known to get incarcerated due to increased osseointegration, bony ingrowth, and bending. These screws can present in various modes of fatigue for which different extraction techniques and sophisticated instruments have been employed, most of which are not readily available at every center. We present a case where a stripped and incarcerated screw was removed using a technique with simple instruments in a resource-limited setting which can be reproduced for any cannulated screw and in any center.