Management of Calcar-Femoral Destruction, Lesser Trochanteric Avulsion Fracture and Total Hip Arthroplasty: Rare Complex Intertrochanteric Fracture Treated at Kilimanjaro Christian Medical Centre, Northern Zonal Referral Hospital
DOI:
https://doi.org/10.47941/ijhs.4018Keywords:
Calcar-Femoral Destruction, Hip mechanics, Lesser Trochanteric Avulsion, Intertrochanteric fracture, Total Hip ReplacementAbstract
Purpose: Our current case study aims to report and explain in depth the complexity of rare traumatic hip injury, mechanism of injury, clinical presentation, current gold-standard treatment option and expected long-term functional outcome.
Methodology: A convenience sampling method was used whereby 1 male patient aged 75 years was approached with a complete displaced femoral neck fracture, calcar distraction and lesser trochanter avulsion fracture. The patient underwent a total hip replacement procedure (Total Hip Arthroplasty). The patient enrolled in the study was ambulant without assistance before injury and the study was conducted in the orthopedics department at Kilimanjaro Christian Medical University College [KCMC], Moshi, Kilimanjaro, Tanzania.
Findings: We found a complete disruption of the calcar femoral component, a complete lesser trochanteric avulsion fracture, and displacement with 360-degree rotation of the femoral head. We also found the femoral head with no sign of bone-to-bone union. Findings from the case study concluded that the preferred management of a neglected severe comminuted fracture around the femoral neck involving complete calcar destruction with rotation of the head and possible avascular femoral head in a 75-year-old patient was emergent open surgical removal of the head, lesser trochanter reconstruction, and total hip replacement [THR]. However, children and young adults pays a significant attention that may need hip preservation or same procedure depending on the severity of the injury.
Unique Contribution to Theory, Practice and Policy: It was recommended to orthopedic and trauma emergence surgeon to careful take a history from the patient with a hip injury, especially an elderly patient, examine and order radiological investigation to immediately diagnose the fracture and determine whether it involve calcar femoral destraction or a complex intertrochanteric fracture. An emergency surgical posterior lateral [Kocher-Langenbeck] or anterior [Watson-Jones] approach, etc. must be immediately adopted without delay to remove the head and replace it with an artificial hip component [THR- total hip replacement/ arthroplasty] by an advanced and experienced orthopaedic hip surgeon to restore hip function, hip biomechanics, and pain management.
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Copyright (c) 2026 Dr. Elibariki J. Munuo, Dr. Faiton N. Mandari , Dr. Elifuraha Maya, Dr. Antony Pallangyo, Dr. Regnald Shoo, Dr. Rogers Temu, Dr Honest Massawe, Dr. Stephen Augusti Minja
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