Intramedullary nail for the surgical treatment of unstable fractures of the femur in previously amputated patients
DOI:
https://doi.org/10.31053/1853.0605.v78.n1.28020Keywords:
amputation stumps, lower extremity, femoral fracturesAbstract
Introduction: Femoral fractures in previously amputated patients (PAP) have been poorly reported in international literature, however it is worth mentioning that advances in the manufacture of orthotics for lower limbs have allowed these patients to remain functionally active. Surgery is then an option but difficulties may appear in positioning the patient for surgery due to the absence of the foot or ankle from where to pull and optimize the fracture reduction.
Objective: We report 3 cases of PAP with ipsilateral unstable femur fractures, treated surgically with cervicodiaphyseal endomedular nail. The surgical technique used in each case is described.
Results: Good long-term results were obtained demonstrating the effectiveness of surgical treatment and the reduction technique used.
Conclusion: Surgical treatment of unstable fractures of the proximal femur with an endomedullary nail should be considered a valid therapeutic option.
Downloads
References
1. Alvarez-Nebreda ML, Jiménez AB, Rodríguez P, Serra JA. Epidemiology of hip fracture in the elderly in Spain. Bone. 2008 Feb;42(2):278-85. doi: 10.1016/j.bone.2007.10.001.
2. Feldstein AC, Black D, Perrin N, Rosales AG, Friess D, Boardman D, Dell R, Santora A, Chandler JM, Rix MM, Orwoll E. Incidence and demography of femur fractures with and without atypical features. J Bone Miner Res. 2012 May;27(5):977-86. doi: 10.1002/jbmr.1550.
3. Silveira VA, Medeiros MM, Coelho-Filho JM, Mota RS, Noleto JC, Costa FS, Pontes FJ, Sobral JB, Aguiar RF, Leal AC, Clemente CM. Incidência de fratura do quadril em área urbana do Nordeste brasileiro [Hip fracture incidence in an urban area in Northeast Brazil]. Cad Saude Publica. 2005 May-Jun;21(3):907-12. Portuguese. doi: 10.1590/s0102-311x2005000300025.
4. Bagur A, Mautalen C, Rubin Z. Epidemiology of hip fractures in an urban population of central Argentina. Osteoporos Int. 1994 Nov;4(6):332-5. doi: 10.1007/BF01622193.
5. Young S, Banza LN, Hallan G, Beniyasi F, Manda KG, Munthali BS, Dybvik E, Engesæter LB, Havelin LI. Complications after intramedullary nailing of femoral fractures in a low-income country. Acta Orthop. 2013 Oct;84(5):460-7. doi: 10.3109/17453674.2013.850014.
6. Rethnam U, Yesupalan RS, Shoaib A, Ratnam TK. Hip fracture fixation in a patient with below-knee amputation presents a surgical dilemma: a case report. J Med Case Rep. 2008 Sep 9;2:296. doi: 10.1186/1752-1947-2-296.
7. Davarinos N, Ellanti P, McCoy G. A Simple Technique for the Positioning of a Patient with an above Knee Amputation for an Ipsilateral Extracapsular Hip Fracture Fixation. Case Rep Orthop. 2013;2013:875656. doi: 10.1155/2013/875656.
8. Ochi H, Baba T, Hamanaka T, Ozaki Y, Watari T, Homma Y, Matsumoto M, Kaneko K. Safe and Effective Reduction Technique for Intertrochanteric Fracture with Ipsilateral Below-Knee Amputated Limb. Case Rep Orthop. 2017;2017:2672905. doi: 10.1155/2017/2672905.
9. Lee BH, Ho SW, Kau CY. Surgical Fixation of a Comminuted Inter-Trochanteric Fracture in a Patient with Bilateral Below Knee Amputation. Malays Orthop J. 2018 Mar;12(1):54-56. doi: 10.5704/MOJ.1803.013.
10. Denton JR, McClelland SJ. Stump fractures in lower extremity amputees. J Trauma. 1985 Nov;25(11):1074-8.
11. Pyka RA, Lipscomb PR. Fractures in amputees. J Bone Joint Surg Am. 1960 Apr;42-A:499-509.
12. Bowker JH, Rills BM, Ledbetter CA, Hunter GA, Holliday P. Fractures in lower limbs with prior amputation. A study of ninety cases. J Bone Joint Surg Am. 1981 Jul;63(6):915-20.
13. al-Harthy A, Abed R, Campbell AC. Manipulation of hip fracture in the below-knee amputee. Injury. 1997 Oct;28(8):570. doi: 10.1016/s0020-1383(97)00118-6.
14. Ercin E, Baca E, Altun S, Bilgili MG, Kural C, Basaran SH. Intertrochanteric fractures in patients with lower limb amputation. Int J Clin Exp Med. 2016 Jul 30;9(7):13238–43.
15. Li S, Yin Y, Zhang R, Chen W, Zhang Y. Minimally invasive treatment for fractures of lower extremity amputees using a rapid reductor. Int Orthop. 2019 Jun;43(6):1473-1478. doi: 10.1007/s00264-018-4072-y.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The generation of derivative works is allowed as long as it is not done for commercial purposes. The original work may not be used for commercial purposes.
How to Cite
