Fracture around proximal femur are a commonly encountered fracture in the older population with a globally increasing incidence. The incidence of the fracture around proximal femur also rises with age. Among the fractures of proximal femur the incidence of intertrochanteric fracture is around 55 % fracture neck of femur is around 32%.

Fractures around the hip are associated with increased mortality rate, incidence being around 8-11% at the end of 30 days and 20-30% at the end of 01 year. A delay in surgery is due to various factors  such as associated co-morbidities requiring pre-operative optimization  in these group of patients and subsequent surgery readiness and resource availability factors such as high volume of cases.

In order to achieve the goals of fracture management the options are primarily surgical with options including reduction and internal fixation or arthroplasty. Arthroplasty can be either Hemi-replacement Arthroplasty (HRA) or Total Hip Arthroplasty (THA). HRA in current practice is of two types: unipolar and bipolar. HRA is generally indicated in older patients with a aim to regain early mobilization and better functional results. HRA prevents the bed ridden state and thus avoids the complications associated with recumbency.

In order to achieve better functional results following HRA the hip biomechanics need to be restored to its native state. The femoral offsets and limb length are the factors that decide the biomechanics of the operated hip. Inability to restore the leg length has shown to be associated with back pain, gait abnormalities, dislocation, prosthesis loosening and poor functional capacity.

Incidence of limb length discrepancy following a HRA with a unipolar prosthesis is as high as 50% when the difference is minimum 10 mm. whereas in bipolar Arthroplasty the incidence decreases but is more when compared to THA

There are various means of reducing the incidence of LLD described in literature in patients undergoing Total Hip Arthroplasty. These methods were broadly classified by Khanduja et al  into 03 groups a) those which rely on preoperative templating and determination of the osteotomy site with intra-operative determination of the osteotomy site in relation to the lesser trochanter; b) those using intra-operative pelvic and femoral markers for reference and; c) experimental methods which employ complex mathematical calculations and ultrasound probes to measure leg lengths accurately. 

However there is limited available literature on methods of reduction of limb length discrepancy in patients of proximal femur fracture undergoing Hemi-replacement Arthroplasty. Methods used are taking reference of the greater trochanter in relation to head of femur on normal side and pre-operative templating and estimating the size of prosthesis 

This study will be undertaken at a tertiary care center in western part of India in patients of fracture of proximal femur undergoing Hemi-replacement Arthroplasty and wherein Pre-operative Scaled Radiograph shall be taken and a novel technique using fixed accessible landmarks will be used to assess the level of cuts intraoperatively with a aim to achieve equal limb length or minimize limb- length discrepancy.