SM 62 years female (follow up case of left Total Hip Replacement in 2010) fell down at home and sustained periprosthetic fracture of femur. With increasing number of hip replacements periprosthetic fracture are also becoming common. Managing this fracture is difficult as they are prone to delayed and non union. We routinely get patients with periprosthetic fracture in our department and with time we have gained expertise in treatment of these fractures. In this patient, implant was well fixed so we did Open Reduction and internal fixation (long reverse Distal Femoral Locking Plate). Patient is comfortable and walking with walker.
Total hip replacement(THR) in Old Fracture Dislocation of Hip 58 years old gentleman presented to us with complains of pain around left hip and difficulty in walking. He had a history of road traffic accident 1 years back and sustained fracture dislocation of left hip, for which he had undergone Open Reduction Internal Fixation elsewhere. Now he had developed secondary osteoarthritis of hip with dislocated head and shortening of left leg. He has undergone uncemented Total hip replacement at Sant Parmanand Hospital. Intraoperatively posterior acetabular wall defect was reconstructed using bone graft and fixed with screws. He has regained his normal leg length and his walking comfortably without any support and pain free.
Total hip replacement(THR) in Subtrochanteric Fracture Femur with Osteoarthritis Hip 65 years old gentleman presented to us following a trivial fall at home and sustained subtrochanteric fracture of right femur. He had a history of fracture acetabulum of right hip 5 years back and had developed painful osteoarthritic hip. He has undergone uncemented Total hip replacement at Sant Parmanand Hospital . The fracture has been stabilized using fully porous coated long femoral stem with encirclage wires. Both his problems of osteoarthritis hip and subtrochanteric fracture have been tackled by the same surgery. Patients has been discharged and has been mobilized the very next day from surgery and he is walking comfortably.
June-2014:Total Hip Replacement for Neglected Fracture Dislocation of Hip. Facebook case
This patient, a 44 years old gentleman from Bangladesh, has presented to us with deformity at right hip with shortening of right lower limb. He had a history of road traffic accident in 2012 and was managed primarily in Bangladesh. He had a fracture dislocation of right hip which was missed initially by the primary surgeon. The fresh radiograph showed dislocated right hip with changes suggestive of AVN of femoral head. CT scan of pelvis with 3D reconstruction was done and revealed posterior acetabular wall defect with dislocated hip. Now he has undergone right uncemented Total Hip Replacement with reconstruction of acetabular defect using bone graft fixed with screws and trabecular metal continuum shell. His deformity and shortening of right lower limb has been corrected. He has been discharged and walking comfortably and painfree without any support.
Total Hip Replacement(THR) following Surgically Intervened Fracture acetabulum with Implant in situ 45 years old gentleman operated case of fracture acetabulum with ORIF with plating done in 2008. Patient now presented with pain around left hip and difficulty in walking. On examination patient had grossly decreased movement at left hip. Radio-graphically suggestive of secondary osteoarthritis left hip with implant in situ. Now he has undergone uncemented Total Hip Replacement. Intraoperatively plate was visible intraarticularly, so one plate was cut and partially removed. Now patient has been discharged and walking comfortably and pain free.