Background: The leg length discrepancy in neglected fracture neck of the femur is a vital problem in active patients. The equalization of this discrepancy is important in total hip replacement, so we decide to do our study about such an important subject. Objectives: To equalize of the leg length discrepancy with total hip replacement in neglected fracture neck of the femur. Methods: This is a prospective observational study of among neglected fracture neck of the femur and leg length discrepancy. The study conducted from October 2024 to December 2025, depending on careful history and physical examination, leg length measurements and radiography of the pelvis at Mosul city, Al Salam Teaching Hospital, Republic of Iraq. The study included traumatized patients who aged 50 years and above, with fracture neck of femur for more than 3 weeks and patients with shortening above greater trochanter, while patients who aged less than 50 years having fracture neck of femur less than 3 weeks, shortening above or below greater trochanter and those with open injuries were excluded from the study. Results: The study includes 26 patients who had fracture neck of femur with LLD (shortening) confirmed by clinical and radiographical methods and treated by THA. The number of males was 12 (46.2%) while the number of females was 14 (53.8%). 63.1 years (50-85 years). The medium of fracture duration was 7 month (25 days to 10 years).16 patients (61.5%) had equalization of leg length discrepancy, 8 patients (30.8%) had incomplete correction (shortening), and 2 patients (7.7%) had leg over lengthening in comparison to other side. There is a significant equalization of leg length discrepancy after surgery with the mean of real measurements increase from (83.5± 5cm) before surgery to (85.57±5.2 cm) on last follow up measurements while the difference in mean value between measurements before and after surgery is (2.07 cm) with the corresponding p value (0.021). Conclusion: Leg length discrepancy is common in neglected fracture neck of the femur. The equalization of this discrepancy is significantly obtained with total hip replacement using direct clinical method (tape measure) of leg length measurement.
*Dr. Ahmed Sedeeq Majeed Alshakarchy (Sun,) studied this question.