Intertrochanteric Femur Fracture in a High-Above-Knee Amputee: Technical Tips for Intraoperative Planning and Implant Selection with Literature Review.

Abstract

Introduction: Intertrochanteric (IT) fractures are rarely reported in amputation stumps.

Case report: This report presents the case of an elderly male with a right above-knee amputation who sustained an ipsilateral IT fracture. He had undergone amputation 3 years prior and was mobilizing independently with a prosthetic limb. The current injury occurred due to the rollover of a four-wheeler in which he was traveling. A proximally sized femoral nail was selected for fracture fixation, with the goal of internal splinting across the entire residual femoral length. Postoperatively, the patient resumed use of his previous prosthesis without difficulty.

Conclusion: Treatment goals in such cases should include preservation of stump length, avoidance of prosthesis socket revision, prevention of peri-implant fractures and implant failure, and the use of load-sharing implants in the lower extremity stump. In addition, enabling the patient to return to their prior level of activity should be a key therapeutic objective.