We describe a case of a femoral neck fracture occurring 51 years after a hip arthrodesis. This rare lesion in an obese woman was treated with a straight supracondylar nail with proximal and distal locking inserted retrograde from the subtrochanteric area into the ileum. Full weight bearing was achieved within 1 week postoperatively, and union was present 3 months following the operation.

Not only is hip arthrodesis an established method for treating septic arthritis, 1,2 but also it was commonly used for the treatment of osteoarthritis prior to the introduction of hip arthroplasty. It still has a therapeutic role in the management of degenerative hip disease in adolescents and young adults. 3–11 Various techniques of hip arthrodesis have been described in the literature using plates, 5,8,11–15 external fixators, 2,9,16,17 and intramedullary nails. 18–20 Although there are sporadic reports about nonunion and malposition, 21,22 we are not aware of a previous publication dealing with the management of a fracture below an arthrodesed hip. We report such a case of a femoral neck fracture occurring 51 years after a hip arthrodesis.