EVALUATON OF CALCAR GRAFTING IN HIP HEMIARTHROPLASTY FOR COMMINUTED INTER-TROCHANTERIC FEMUR FRACTURES IN ELDERLY

Abstract

Introduction: Treating intertrochanteric fractures in elderly with osteosynthesis is challenging, and is attributed to multiple factors like poor bone stock, difcult fracture pattern, and non orthopaedic complications arising due to periods of recumbency associated with internal xation. Hip replacement has come forward as a viable option for treating these cases, but it has its own share of difculties, such as limb length discrepancy, implant subsidence, long term implant stability and a greater cost. This study aimed at evaluating the utility if calcar strut grafting in dealing with these issues. Material And Methods: A total of 30 patients, with age more than 60 years, with comminuted intertrochanteric fractures, with postero-medial bone deciency, were treated with hemiarthroplasty, with augmentation with calcar strut grafting. The graft was prepared from the calcar region of the head and neck part of the femur and placed between the decient medial femoral cortex and medial edge of the implant. Result: In 24 out of the 30 patients, the graft got incorporated at its place without displacement. Shortening was seen in 4 patients, of which 2 reported a shortening of more than 2 centimetres. Conclusion: We can concludethat hemiarthroplasty has come forward as a viable and safe treatment modality for management of comminuted inter-trochanteric fractures in elderly patients.Calcar grafting as described here is useful in minimizing the subsidence of the implant and in maintaining the limb length, it facilitates early rehabilitation and quicker return normal activities