English

Abstract

The advent and increasing use of joint replacement for various conditions has led to a new group of fractures- the periprosthetic fractures. The hip joint is commonly involved in this group. The management of these fractures is complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires. In General Hospital, health and economic problems of poor patients warrants a need for alternative simple technique for management of such cases. In this article we discuss a case of peri-prosthetic fracture of shaft of femur in a lean, short statured lady, reluctant for blood transfusion due to previous reaction secondary to minor incompatibility, treated by use of ender nail. CASE REPORT: 55 year female, lean and short statured lady, poorly nourished, from rural area, was brought to OPD with alleged history of fall about a day back with complaint of pain in left thigh and inability to bear weight and deformity. She underwent hemiarthroplasty (Austin moore prosthesis) for fracture neck femur on same side 2 years back. On examination, there was sub-trochanteric shortening of left lower limb with externally rotation, tenderness present over the junction of upper and middle third of thigh with swelling. Abnormal and painful mobility was elicited at that site. X-ray of pelvis including both hip joint and left thigh revealed peri-prosthetic fracture femur. Blood investigations revealed Hb 7.1. Other relevant investigations especially LFT, RFT were within normal limits. Due to respiratory and cardiac status, she was declared unfit for anaesthesia