Challenges Faced in the Surgical Fixation of a 4 Part Inter-Trochanteric Fracture in a Patient with Ipsilateral Below Knee Amputation and Uncontrolled Diabetes Mellitus

Abstract

Operative treatment of hip fractures in a patient with below-knee amputation on the same extremity poses a great challenge in terms of obtaining an optimal amount of traction for fracture reduction. The absence of the foot and the distal lower limb which makes the positioning difficult and other medical co-morbidities contribute to the same. We present a case report of a 66-year-old man with ipsilateral below-knee amputation who underwent surgical fixation of a comminuted 4-part right intertrochanteric femur fracture. We discuss the pros and cons of various methods and highlight a simple and effective technique of reverse boot traction for fracture reduction. Keywords: Inter trochanteric fracture, 4-part fracture, amputation, diabetes mellitus, reverse boot.