Intramedullary Nail for the Surgical Treatment of Unstable Fractures of the Femur in Previously Amputated Patients

Overview

Journal Rev Fac Cien Med Univ Nac Cordoba

Specialty General Medicine

Date 2021 Mar 31

PMID 33787031

Authors

Franco Luis De Cicco

Lionel Llano

Fernando Diaz Dilernia

Guido Sebastian Carabelli

Danilo Taype Zamboni

Jorge Daniel Barla

Carlos Federico Sancineto

Affiliations

Soon will be listed here.

Abstract

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.

References

Young S, Banza L, Hallan G, Beniyasi F, Manda K, Munthali B . Complications after intramedullary nailing of femoral fractures in a low-income country. Acta Orthop. 2013; 84(5):460-7. PMC: 3822130. DOI: 10.3109/17453674.2013.850014. View

PYKA R, Lipscomb P . Fractures in amputees. J Bone Joint Surg Am. 1960; 42-A:499-509. View

Bowker J, Rills B, Ledbetter C, Hunter G, Holliday P . Fractures in lower limbs with prior amputation. A study of ninety cases. J Bone Joint Surg Am. 1981; 63(6):915-20. View

Ochi H, Baba T, Hamanaka T, Ozaki Y, Watari T, Homma Y . Safe and Effective Reduction Technique for Intertrochanteric Fracture with Ipsilateral Below-Knee Amputated Limb. Case Rep Orthop. 2017; 2017:2672905. PMC: 5446871. DOI: 10.1155/2017/2672905. View

Denton J, McClelland S . Stump fractures in lower extremity amputees. J Trauma. 1985; 25(11):1074-8. View

Alvarez-Nebreda M, Jimenez A, Rodriguez P, Serra J . Epidemiology of hip fracture in the elderly in Spain. Bone. 2007; 42(2):278-85. DOI: 10.1016/j.bone.2007.10.001. View

Bagur A, Mautalen C, Rubin Z . Epidemiology of hip fractures in an urban population of central Argentina. Osteoporos Int. 1994; 4(6):332-5. DOI: 10.1007/BF01622193. View

Silveira V, das Chagas Medeiros M, Coelho-Filho J, Mota R, Noleto J, Costa F . [Hip fracture incidence in an urban area in Northeast Brazil]. Cad Saude Publica. 2005; 21(3):907-12. DOI: 10.1590/s0102-311x2005000300025. View

Lee B, Ho S, Kau C . Surgical Fixation of a Comminuted Inter-Trochanteric Fracture in a Patient with Bilateral Below Knee Amputation. Malays Orthop J. 2018; 12(1):54-56. PMC: 5920262. DOI: 10.5704/MOJ.1803.013. View

10.

Rethnam U, Yesupalan R, Shoaib A, Ratnam T . Hip fracture fixation in a patient with below-knee amputation presents a surgical dilemma: a case report. J Med Case Rep. 2008; 2:296. PMC: 2542403. DOI: 10.1186/1752-1947-2-296. View

11.

Al-Harthy A, Abed R, Campbell A . Manipulation of hip fracture in the below-knee amputee. Injury. 1998; 28(8):570. DOI: 10.1016/s0020-1383(97)00118-6. View

12.

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. 2018; 43(6):1473-1478. DOI: 10.1007/s00264-018-4072-y. View

13.

Feldstein A, Black D, Perrin N, Rosales A, Friess D, Boardman D . Incidence and demography of femur fractures with and without atypical features. J Bone Miner Res. 2012; 27(5):977-86. DOI: 10.1002/jbmr.1550. View

14.

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. 2014; 2013:875656. PMC: 3876688. DOI: 10.1155/2013/875656. View