An 86-year-old female presents to the ED after a ground-level fall after she tripped on the bathroom rug. She reports landing directly on her right side and was unable to ambulate after the fall. Pain is localized to the right hip and worsened with any movement to the right leg. At baseline, she uses a walker around the house and a wheelchair within the community.
HTN, aortic stenosis, hypothyroid, chronic pain syndrome
PSH: prior right femur intramedullary nail
Focused exam of the right lower extremity demonstrates a shortened and externally rotated leg. Worsening groin pain with any manipulation of the right leg. She is unable to perform a straight leg raise. She is neurovascularly intact.
If you choose Hemiarthroplasty and obtain the construct shown below, would you address the stress riser between the implant and retrograde nail to prevent fracture?
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