Femoral shaft perforation: a complication of total hip reconstruction.

Perforation of the femoral shaft by the stem of the prosthesis is a rare, but serious complication following total hip replacement. It is a complication that is avoidable if meticulous attention is given to preoperative planning and intraoperative technique. The major predisposing factors for this complication are previous hip surgery, hip dysplasia, osteoporosis and poor exposure. Every attempt should be made to discover a perforation during surgery and to correct the alignment of the femoral stem. The patients who have experienced this complication have had a poor result suffering pain, loosening or femoral shaft fracture necessitating surgical revision.