We describe a case of an 82-year-old lady with groin pain secondary to an obturator hernia. She was a diagnostic challenge, and 6 years passed before the obturator hernia was discovered. She presented to hospital with symptoms of bowel obstruction, and a computer tomography (CT) scan of her pelvis revealed an incarcerated obturator hernia. Her surgical management included reinforcement of the obturator foramen with sutures. A recurrence of the obturator hernia 2 years later required an extra-peritoneal mesh repair of the defect in the obturator foramen with a good outcome.

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INTRODUCTION Intertrochanteric fractures in osteoporotic bones which are grossly comminuted are highly unstable and difficult to treat. Conservative treatment with traction and prolonged immobilisation lands up with many complications and often fatality. Rate of failure with internal fixation has been found to be high, especially in osteoporotic bones. Revision osteosynthesis is technically demanding and it leads to complications, a second surgical procedure for revision synthesis, arthroplasty or removal of a symptomatic implant is again a risky procedure in elderly patients with lot of comorbidities. The aim of this study was to assess the efficacy of a cemented bipolar hemiarthroplasty with calcar preserving intracapsular osteotomy in the management of unstable trochanteric fractures in elderly patients with osteoporosis. Hemiarthroplasty in unstable trochanteric fractures have been described in the past with varying outcome. The reasons for poor outcome were shortening, varus positioning and abductor insufficiency. This was mainly due to the deficient medial support due to the removal of lesser trochanter and calcar. Recently, free calcar grafting excised from the removed neck for medial support was reported, but in our technique we are preserving the calcar and lesser trochanter with all its soft tissue and muscle attachments.