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Traumatic femoral shaft fractures distal to a hip resurfacing arthroplasty (HRA) are rare. Only four cases have been described in which an intramedullary nail was used to treat the fracture. We present the first case in the literature of a pathological femoral shaft fracture distal to a HRA, and describe its treatment with an anterograde intramedullary femoral nail with proximal locking screws placed into the femoral head overlapping the HRA stem. This demonstrates that the presence of a hip resurfacing arthroplasty does not preclude from utilising an intramedullary nail with recon screws to stabilise a pathological fracture.

Intramedullary femoral nail fixation for A pathological fracture distal to A resurfacing arthroplasty