Uncemented hemiarthroplasty in a case of post-polio residual paralysis patient with transcervical femur fracture with dysplastic femur: A surgical technical challenge

Abstract

Introduction: Technical difficulties in managing a case of transcervical femur fracture in post-polio residual paralysis patient with dysplastic femur. Case Report: We present a case of a 66 year male with Post-Polio residual Paralysis walking with Hand to knee gait who sustained a transcervical Femur fracture. The difficulties faced in this case were narrow medullary canal, coxa valgus, dysplastic greater trochanter, hypoplastic lesser trochanter, Shallow acetabulum, inability to compare the length after insertion of trial implant with the opposite limb due to underdeveloped and shortened affected limb.Conclusion: We try to emphasise on the preoperative preparations that need to be done in terms of CT scan with pre operative estimation of canal diameter, keeping a back-up of an array of implants including CDH hip stems, technique of measuring the vertical and horizontal offset before neck osteotomy and extraction of the head and recreating the offset after implantation, increased anteversion of the hip to prevent dislocation due to shallow acetabulum, and proper closure of the capsule.